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Self-Help Delivers Modest Gains for Sleep Problems

17 May

Researchers from Vrije Universiteit in Amsterdam, The Netherlands, examined whether a self-help intervention might offer an inexpensive and more accessible alternative to face-to-face therapy for the non-pharmacologic treatment of insomnia. 

They conducted a meta-analysis of randomized controlled studies examining the effects of self-help interventions for insomnia, identified through extensive searches of bibliographical databases.  They examined the effects of self-help on different sleep outcomes, in comparison with both wait list controls and face-to-face treatments.

Ten studies with a total of 1000 subjects were included. The intervention did improve sleep efficiency (d=0.42; p<0.05), sleep onset delay (d=0.29; p<0.05), waking after falling asleep (d=0.44; p<0.05) and general sleep quality (d=0.33; p<0.05) but not total sleep time (d=0.02; p>0.05).

The sleep improvements were maintained over the long term. Symptoms of anxiety and depression also decreased after self-help (d=0.28; p<0.05 and d=0.51; p<0.05, respectively).

Although based on a very limited number of studies, the face-to-face treatments did not show statistically significant superiority to the self-help treatments. However, the authors caution that the effect sizes associated with self-help treatments might be overestimated due to publication bias.

The study concludes that the beneficial effects of self-help treatments are small to moderate, and they may be a useful addition to existing treatment options. 

Citation:  van Straten A, Cuijpers P.Self-help therapy for insomnia: a meta-analysisSleep Medicine Review. 2009. Feb; 13 (1): pages 61-71.  Epub 2008 Oct 26. This email address is being protected from spambots. You need JavaScript enabled to view it.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award