Insomnia

Eus van Someren (NIN)
Jeroen Benjamins (NIN)
Kim Dekker (NIN)

Insomnia, is a condition that affects about 10% of the Western population and has severe consequences for health (increased risk of depression, obesity and cardiovascular problems) and society (reduction in productivity, increased sick leave and care request). Pharmacological treatment is far from optimal, not recommended since the 2005 NIH consensus report (National Institutes of Health 2005, Sleep), and at present no longer supported by health care insurance. Better treatments are desperately needed. Chronobiological treatment (CT) and cognitive behavioral therapy (CBT) (Morin et al. 2009, JAMA) appear safer and have more sustained effects. Their combination, investigated in only one study, may even be more effective. A problem for large-scale implementation is that there are hardly any skilled therapists. A second problem is that the people with insomnia most likely represent a heterogeneous mix of different subtypes, with different underlying causes and expected treatment response.

We aim to develop and validate a systematic approach that includes chronobiological treatment (light, exercise and warmth) and outcome and compliance monitoring equipment, linked to web-based cognitive behavioral therapy modules. Web-based therapy has a high potential and solves the discrepancy between care needed and care available. The essential step to identify who most benefit from the different components that make up the treatment will be realized by testing the efficacy on carefully selected subtypes of insomnia, that are presently being pursued through the Netherlands Sleep Registry (NSR).