Sleep Healthy Using the Internet

Feb 25, 2014

As many as three in ten adults have trouble sleeping.  They spend more than $32 billion a year on medications, books and recordings, hoping to get a good night’s rest. 

Now, a team at the University of Virginia is offering another solution online.  

54-year-old Jonathan West is the father of four and a consultant who helps people figure out how to pay for college.  He doesn’t lie awake wondering how he’ll finance his own children’s education, but for more than a decade he’s had trouble sleeping.

“I would wake up early and not get back to sleep, or I would have trouble falling asleep, either one.”
As he searched for a solution online, he came across a behavior modification program called SHUTi – short for sleep healthy using the Internet.  It’s patterned after what mental health professionals do to treat insomnia, and it’s been proven effective in three different studies  Frances Thorndike and Lee Ritterband are clinical psychologists at the University of Virginia.

“We have them collect some information in a sleep diary, so we can really understand what’s going on for them.  How much time they’re spending in bed.  How much time they’re sleeping when they’re in bed, and how many times are they waking in the middle of the night.  and then by looking at that information, we recommend strategies – we try to change the things that are really getting in their way.  Problems can start for a whole lot of different reasons, but it tends to be certain behaviors or thoughts we may have that keep that sleep problem in place.”

After the first week of gathering data, SHUTi defines a sleep window based on a user’s individual information.  That’s the only time he or she is allowed to sleep.  Jon West, for example, shared details on his sleep patterns and indicated the time he’d like to get up in the morning.

“Which I selected as 5:45, and it had me going to bed at 12:25 in the morning.  I thought there had been a mistake between AM and PM or something, because who goes to bed at 12:25 on a work night?  But that was my time, and so that gave me a few extra hours every day, because I wasn’t lying in bed.  So I could watch basketball, or read or do whatever, which was nice, but it was hard to stay awake until 12:30 in the morning.”

If he slept well, the sleep window would expand.  If he had a bad night, the program kept him from worrying about it.

“I had this ingrained thought about much sleep I needed, so I kept thinking, ‘I need more sleep.  I need more sleep,’ but  I was functioning okay.  I was doing fine, and it was nice to be able to actually see on my worksheet that I was sleeping through the night.”

And there were video vignettes to provide further reassurance, showing West he was not alone.

The six-week program costs $129, and Thorndike admits you could get much of this information from a book, but she says there’s an important difference.

“Some of the information is very similar, but we can really use the technology to make it more engaging or interactive and more personal.”

She adds that this online approach is more convenient and a lot cheaper than working one-on-one with a psychologist.  Scientists in Australia are trying to determine whether SHUTi can help people recover from or avoid depression, while researchers in Denmark hope to learn if this automated online program can help breast cancer survivors  worry less and sleep more.