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Takeaway: Veteran access to Cognitive Behavioral Therapy for Insomnia (CBTI), a first-line insomnia intervention, is limited by a number of factors. In partnership with the Office of Mental Health and Suicide Prevention, and as an HSR Career Development Awardee, Christi Ulmer, PhD, with colleagues, developed SleepEZ, a digital CBTI course that mitigates access barriers. The course has been accessed more than 90,000 times by almost 50,000 users and had 950 new users per month in FY2023.
Insomnia is pervasive among Veterans and is a risk factor for the most common mental health problems treated in VA healthcare, including depression, PTSD, and suicidality.[1] Veteran access to Cognitive Behavioral Therapy for Insomnia (CBTI), a first-line multi-component insomnia intervention, is limited by a number of factors, including an inadequate number of trained providers, the inconvenience of weekly treatment offered exclusively in a clinical setting, and the distance to VA facilities among rural Veterans. A self-management strategy for insomnia can bridge the gap between unavailable resources and high demand for services and has the potential to improve outcomes across multiple life domains.
VA is committed to helping Veterans with insomnia and offers Veterans a range of treatments to address sleep problems. Cognitive Behavioral Therapy for Insomnia (CBTI) is recommended as the best approach to treat insomnia.
To increase Veterans’ access to insomnia treatment, Christi Ulmer, PhD, a former HSR Career Development Awardee with HSR’s Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), worked with the Office of Mental Health and Suicide Prevention (OMHSP) to develop Path to Better Sleep, a web page that features sleep-focused content for Veterans. The page features direct links to didactic content and courses that can help Veterans who struggle with sleep problems, and includes a link to SleepEZ, a CBTI-based digital insomnia treatment course developed by Dr. Ulmer and colleagues. SleepEZ features clips of Veterans who share their personal stories and successes in achieving better sleep with CBTI. It is free, requires no registration or personal information, and is available on demand through a smartphone, laptop, or tablet. The OMHSP continues to update and improve the course with the help of subject matter experts, including Dr. Ulmer and Earl Crew, PhD, a clinical health psychologist at the Michael E. DeBakey VA Medical Center. Additional sleep-related content might be added to the Path to Better Sleep page in the future to address other sleep difficulties common among Veterans, such as nightmares.
SleepEZ has been accessed more than 90,000 times by almost 50,000 users since launching in 2018 and had 950 new users per month in FY2023. Clinicians routinely recommend the course to Veterans who seek self-directed treatment or have limited face-to-face CBTI resources. A provider-supported SleepEZ intervention is currently being evaluated with HSR funding since Veterans are more likely to engage in treatment when working with a provider.
VA’s Office of Mental Health and Suicide Prevention
