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A Randomized Controlled Trial of an Internet Intervention for Adults with Insomnia: Effects on Comorbid Psychological and Fatigue Symptoms


  • This manuscript is a secondary data analysis from a previously published study.

  • Subsequent to conducting this study, Drs. Ritterband, Thorndike, Gonder-Frederick, and Morin became equity owners in a company that now makes the Internet intervention commercially available. The company had no role in preparing this manuscript.

  • This research was funded by grant R34MH70805 from the National Institutes of Health/National Institute of Mental Health. We thank Jonathan Cole Sletten and Dominion Digital for their expertise in developing the SHUTi program. Also, we thank William Pascarella, B.S., for his technical support, Michelle Hilgart, M.Ed., for design expertise, and both Drew K. Saylor, B.A., and Elaine T. Bailey, PhD, for their help conducting the trial. Last, we thank Jennifer Beard, PhD, for her assistance with reviewing the relevant literature.

Please address correspondence to: Frances P. Thorndike, University of Virginia Health System, Department of Psychiatry and Neurobehavioral Sciences, Behavioral Health & Technology, P.O. Box 801075, Charlottesville, Virginia 22908. E-mail:



Insomnia is frequently comorbid with other medical and psychological disorders. This secondary data analysis investigated whether an Internet-delivered cognitive behavioral therapy for insomnia (CBT-I) intervention could also reduce comorbid psychological and fatigue symptoms.


Data from a pilot randomized controlled trial (RCT) testing the efficacy of Internet-delivered CBT-I relative to a waitlist control was used to examine changes in symptoms of depression, anxiety, mental health quality of life (QOL), and fatigue.


Group by time interactions from repeated measures analyses revealed significant post intervention improvements in Internet participants (n = 22) relative to control participants (n = 22) on all psychological symptoms, mental health QOL, and fatigue. A small post hoc subsample of Internet participants with mild or moderate depression also showed large effect size changes in these constructs (depression, anxiety, mental health QOL, and fatigue).


Internet-delivered CBT-I appears to not only improve sleep but also reduce comorbid psychological and fatigue symptoms.