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ACT for sleep - Internet-delivered self-help ACT for sub-clinical and clinical insomnia: A randomized controlled trial (Pages 119-127)

Volume 12, April 2019, Pages 119-127


Päivi Lappalainen, Sitwat Langrial, Harri Oinas-Kukkonen, Joona Muotka, Raimo Lappalainen



Sleep disturbances are a common health problem. New and more accessible alternatives are needed to improve the availability of psychological treatments for insomnia.


The aim of the present study was to investigate the effects of a self-help Acceptance and Commitment Therapy-based web-intervention for sleep disturbances.


Participants (N = 86) reporting symptoms of insomnia were randomly assigned to an Internet-delivered ACT (iACT, n = 43) or a control condition (WLC, n = 40) and assessed with standardized self-report measures related to sleep (ISI, BNSQ, ESS, DBAS), psychological symptoms (BDI-II, SCL-90), life satisfaction, and ACT-related processes (AAQ-2, FFMQ, and WBSI) at pre- and post-measurement, and at 6-month follow-up (iACT group only). Participants in the study condition received a 6-week Internet intervention based on the processes of ACT, enhanced with weekly automated email-based reminders. No therapist support was offered during the intervention.


Hierarchical linear modeling analysis showed significant differences between the treatment and the control group in sleep quality and duration (BNSQ), sleep-related dysfunctional cognitions (DBAS), and severity of depressive symptoms (BDI-II) from Pre to Post-measurement in favor of the intervention group. The intervention showed also significant positive impact on thought suppression (WBSI), but no effect on general psychological flexibility and mindfulness. The between group effect sizes at Post were moderate or small (d = 0.21–0.53). In the iACT group, changes achieved in sleep quality and duration, symptom measures and suppression of thoughts during the intervention were maintained during the 6-month follow-up period.


We conclude that unguided Internet-delivered Acceptance and Commitment Therapy can be effective in treating symptoms of insomnia and offers a useful addition to existing treatment options.

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