Harvard Mental Health Letter

Commentary: Internet-based insomnia treatment

The fifteenth-century English King Henry felt the burden of leadership. In Henry IV, Part 2, Shakespeare showed the king yearning for sleep, "Nature's soft nurse," while ruing an irony: although thousands of his poor subjects were sleeping soundly, the power of his crown was no match for his insomnia.

If King Henry were alive today, he would have no shortage of health care providers offering to help him with this problem. But most people nowadays don't get the royal treatment. Although symptoms of insomnia are very common (one in three U.S. adults has them), relatively few Americans seek professional help. Instead they may reach for an over-the-counter remedy, alcohol, or some other substance on the occasional sleepless night.

In the short term, a prescription medication can be useful, but — over time — it is not as good as CBT at helping people to sleep better. Once a patient learns and practices principles of sleep hygiene, the positive effects can last well beyond the final therapy session.

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