Researchers from Vrije Universiteit Amsterdam in The Netherlands explored whether self-help could offer an inexpensive and more accessible alternative to face-to-face treatment, comparing non-pharmacological therapies only.

Ten studies with a total of 1000 subjects were included. The self-help style of intervention was found to improve sleep efficiency (d=0.42; p<0.05), sleep onset latency (d=0.29; p<0.05), waking after sleep onset (d=0.44; p<0.05) and 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 longer 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). The face-to-face treatments did not show statistically significant superiority to the self-help treatments.

The study concludes that the effects of self-help treatments are small to moderate.  They may well constitute a useful addition to existing treatment options, especially when integrated into a stepped care approach.

Citation:  van Straten A, Cuijpers P. Self-help therapy for insomnia: a meta-analysisSleep Medicine Reviews.  2009 Feb;13(1):61-71. Epub 2008 Oct 26. [email protected]