OBJECTIVE: Insomnia is a common complaint among cancer survivors. Fortunately, 
cognitive-behavioral therapy for insomnia (CBT-I) has been shown to be an 
effective treatment in this population. However, it is rarely implemented given 
its limited availability. To address this barrier, we examined the ability of an 
easily accessible online CBT-I program to improve insomnia symptoms in cancer 
survivors.
METHODS: Twenty-eight cancer survivors with insomnia were randomly assigned to 
either an Internet insomnia intervention (n = 14) or to a waitlist control group 
(n = 14). The online program, Sleep Healthy Using The Internet, delivers the 
primary components of CBT-I (sleep restriction, stimulus control, cognitive 
restructuring, sleep hygiene, and relapse prevention). Pre- and post-assessment 
data were collected via online questionnaires and daily sleep diaries.
RESULTS: Participants in the Internet group showed significant improvements at 
post-assessment compared with those in the control group in overall insomnia 
severity (F(1,26) = 22.8; p<0.001), sleep efficiency (F(1,24) = 11.45; P = 
0.002), sleep onset latency (F(1,24) = 5.18; P = 0.03), soundness of sleep 
(F(1,24) = 9.34; P = 0.005), restored feeling upon awakening (F(1,24) = 11.95; P 
= 0.002), and general fatigue (F(1,26) = 13.88; P = 0.001). Although other group 
× time interactions were not significant, overall adjusted effect sizes for all 
sleep variables as well as for fatigue, depression, anxiety, and quality of life 
ranged from small to large.
CONCLUSIONS: CBT-I delivered through an interactive, individually tailored 
Internet intervention may be a viable treatment option for cancer survivors 
experiencing insomnia.