Struggling to sleep after the time change? You’re not alone – daylight saving time causes temporary insomnia symptoms in as many as 35% of adults due to the sudden change in schedule, according to the American Academy of Sleep Medicine. Roughly a third of those adults will suffer insomnia symptoms year-round.
To find out how to have a better night’s sleep, we checked in with Lee Ritterband, the Jean and Ronald Butcher Eminent Scholars Professor at the University of Virginia School of Medicine and director of the Center for Behavioral Health and Technology, where they research and test interventions for conditions like insomnia.
Q. Exactly what is insomnia and who is most affected by it?
A. Chronic insomnia is a diagnosable disorder that tends to affect 10% to 15% of the population. The main three insomnia-related issues are difficulty falling asleep, waking up in the middle of the night and/or having trouble falling back asleep.
Up to 30% of people experience some insomnia symptoms. It tends to be more common in women than men at a 2 to 1 ratio, although many wonder if this may partially be because women are more likely to report their symptoms.
UVA Professor Lee Ritterband has worked on insomnia treatment for more than 20 years. (Photo by Matt Riley, University Communications)
Q. Are there other groups of people sleep issues impact more?
A. At the Center for Behavioral Health and Technology, we build digital health interventions, including for sleep-related issues. A lot of that work focuses on sleep issues in patients with cancer.
Those diagnosed with cancer have much higher rates of insomnia than non-cancer patients. Our work focuses on the development and testing of fully automated systems that can deliver personalized treatment to individuals as a way of overcoming a lot of the barriers of face-to-face treatment and making help more accessible.
Q. You developed the “SHUTi” program. Can you describe what that is?
A. SHUTi stands for Sleep Healthy Using the Internet. It’s our program that we began developing almost 20 years ago. The software has been licensed and the commercial product, Somryst, has been authorized by the FDA.
SHUTi is based on cognitive behavioral therapy for insomnia, or CBT-I, which is the first-line recommended intervention for insomnia. The problem is that it is not widely accessible because there are not a lot of people trained to provide it. That’s why we thought digitizing it would expand access, and it has.
Q. How does SHUTi work?
A. It’s an intervention that focuses on the thoughts and behaviors that contribute to sleep problems. It includes sleep restriction, stimulus control, cognitive restructuring, sleep hygiene and relapse prevention, which are the primary tenets of CBT-I. Users input details about their sleep every day, and the system uses that data to calculate what we call a “sleep window,” a period of time the user is recommended to sleep and wake up. SHUTi is also filled with interactive elements, videos, illustrations and educational material, similar to what patients would get from an in-person CBT-I provider.
It’s been found to be very effective across the board. Overall, people are experiencing significantly improved sleep.
We have had thousands of people use SHUTi across the country and tens of thousands across the world. It’s been translated into a number of languages, and studies in Canada, Norway, Denmark and Australia have all shown the treatment meaningfully reduced insomnia . In addition, other benefits have included improvements in depression, anxiety and quality of life.
