SHUTi (USA)

Description:

The SHUTi (Sleep Healthy Using the Internet) program is a fully automated, interactive, and tailored web-based program based on the well-established face-to-face cognitive behavioural therapy for insomnia. It provides six sequential modules consisting of an introduction and treatment rationale (Core 1), sleep restriction and stimulus control (Core 2 and 3), cognitive restructuring (Core 4), sleep hygiene (Core 5), and relapse prevention (Core 6). Each module takes 45 to 60 minutes to complete.  An 11-item daily sleep diary is required to advance from the first to the second module so the system can establish an algorithmically defined sleep window. It takes a minimum of six weeks to complete the SHUTi program. Program content is personalised to clients' current sleep patterns and goals. Automated reminder e-mails are an integral part of the program. 

Service URL:
Agency Responsible:
BeHealth Solutions.

Details

Format:
Website.
Intervention Type:
Psychological – CBT.
Course Length:
Long (more than 5 modules). Takes a minimum of 6 weeks
Support Option:
Automated only. Provided through tailored feedback

Target Audience

Primary Category:
Sleep / insomnia.
Secondary Categories:
Depression and Generalised anxiety disorder.
Target Audience:
Adult.
Language:
English.

Access

Fee:
Fee-based. The price depends on the length of the program ranging from $149 to $249
Access:
Closed: Fee required.
Contact Details:

contactus@shuti.net

Research evidence

Research Trials:
7
Research RCTs:
6
Outcome Summary:

Outcome summary: SHUTi has been tested in a series of RCTs in various populations, where it has consistently performed better than controls in improving symptoms of insomnia. In a RCT of 45 adults (1), the SHUTi intervention group showed significant improvements in the Insomnia Severity Index at post assessment compared to a waitlist control group and maintained these improvements at the 6-month follow-up. Time of waking after sleep onsets, sleep efficiency, total sleep time, number of night-time awakenings, and self-ratings of sleep restoration and restfulness on awakening were also significantly improved at the 9-week post assessment in the intervention group. 

In a subsequent RCT of 28 cancer survivors with insomnia (3) , the SHUTi intervention group showed significant improvements in sleep outcomes compared to a waitlist control group, including a large effect size in Insomnia Severity Index score (d=1.85), sleep efficiency, sleep onset latency, number of awakenings, soundness of sleep, and restored feeling upon awakening at post assessment. Another RCT was carried out with 1149 adults (7) recruited via the internet with insomnia and depression, the intervention group saw significantly better reductions in the Insomnia Severity Index (d=1.1) at the 6-week post-intervention compared to attention matched controls. Significant reductions were also found in symptoms of depression and anxiety. 

In a RCT of 303 adults with sleep disturbances (8), SHUTi was tested against an informational control group. The intervention group showed significantly better improvements than controls in Insomnia Severity (d=1.9 within group), as well as other measures including sleep-onset latency, and wake after sleep onset at the post assessment, and remained significant at the 6-month and 12-month follow-up. Another RCT was carried out in Norway with N=181 participants meeting the DSM-IV criteria for insomnia. This study found that the intervention group had significantly better improvements in insomnia severity compared to an informational control group with a large effect size  (d=2.07 between groups). 

In a recent RCT of 255 breast cancer women survivors in Denmark (13), the SHUTi intervention group had significant improvements with large effect sizes observed compared to a waitlist control group in insomnia severity (d=1.17 between groups), sleep quality (d=0.90) and sleep efficiency (d=0.80) at post assessment. 

The evidence available to date suggest that SHUTi consistently results in significant improvements with large effect sizes in the severity of insomnia symptoms, as well as other measures of sleep quality.


Recommended rating, reviewer 1:

Sign up!
Recommended rating, reviewer 2:

Sign up!

Read more about Beacon's Smiley Rating System.

Research paper citations

Research paper citations: 
(1) Ritterband, L. M., Thorndike, F. P., Gonder-Frederick, L. A., Magee, J. C., Bailey, E. T., Saylor, D. K., Morin, C. M. (2009). Efficacy of an Internet-based behavioral intervention for adults with insomnia. Archives of General Psychiatry, 66(7), 692-698.
(2) Thorndike, F. P., Saylor, D. K., Bailey, E. T., Gonder-Frederick, L. A., Morin, C. M., Ritterband, L. M. (2008). Development and perceived utility and impact of an Internet intervention for insomnia. E-Journal of Applied Psychology, 4(2), 32-42.
(3) Ritterband, L. M., Bailey, E. T., Thorndike, F. P., Lord, H. R., Farrell‐Carnahan, L., & Baum, L. D. (2012). Initial evaluation of an Internet intervention to improve the sleep of cancer survivors with insomnia. Psycho‐Oncology, 21(7), 695-705.
 (7) Christensen, H., Batterham, P. J., Gosling, J. A., Ritterband, L. M., Griffiths, K. M., Thorndike, F. P., ... & Mackinnon, A. J. (2016). Effectiveness of an online insomnia program (SHUTi) for prevention of depressive episodes (the GoodNight Study): a randomised controlled trial. The Lancet Psychiatry, 3(4), 333-341
(8) Ritterband, L. M., Thorndike, F. P., Ingersoll, K. S., Lord, H. R., Gonder-Frederick, L., Frederick, C., ... & Morin, C. M. (2017). Effect of a web-based cognitive behavior therapy for insomnia intervention with 1-year follow-up: a randomized clinical trial. JAMA psychiatry, 74(1), 68-75.
(11) Hagatun, S., Vedaa, Ø., Nordgreen, T., Smith, O. R., Pallesen, S., Havik, O. E., ... & Sivertsen, B. (2017). The short-term efficacy of an unguided internet-based cognitive-behavioral therapy for insomnia: a randomized controlled trial with a six-month nonrandomized follow-up. Behavioral sleep medicine, 1-23.
(13) Zachariae, R., Amidi, A., Damholdt, M. F., Clausen, C. D., Dahlgaard, J., Lord, H., ... & Ritterband, L. M. (2018). Internet-Delivered Cognitive-Behavioral Therapy for Insomnia in Breast Cancer Survivors: A Randomized Controlled Trial. JNCI: Journal of the National Cancer Institute.
Additional Evidence:
(4) Thorndike, F. P., Ritterband, L. M., Gonder‐Frederick, L. A., Lord, H. R., Ingersoll, K. S., & Morin, C. M. (2013). A randomized controlled trial of an internet intervention for adults with insomnia: effects on comorbid psychological and fatigue symptoms. Journal of clinical psychology, 69(10), 1078-1093.
(5) Gosling, J. A., Glozier, N., Griffiths, K., Ritterband, L., Thorndike, F., Mackinnon, A., ... & Christensen, H. (2014). The GoodNight study—online CBT for insomnia for the indicated prevention of depression: study protocol for a randomised controlled trial. Trials, 15(1), 56.
(6) Cockayne, N. L., Christensen, H. M., Griffiths, K. M., Naismith, S. L., Hickie, I. B., Thorndike, F. P., ... & Glozier, N. S. (2015). The Sleep Or Mood Novel Adjunctive therapy (SOMNA) trial: a study protocol for a randomised controlled trial evaluating an internet-delivered cognitive behavioural therapy program for insomnia on outcomes of standard treatment for depression in men. BMC psychiatry, 15(1), 16.
(9) Chan, C., West, S., & Glozier, N. (2017). Commencing and persisting with a web-based cognitive behavioral intervention for insomnia: a qualitative study of treatment completers. Journal of medical Internet research, 19(2).
(10) Batterham, P. J., Christensen, H., Mackinnon, A. J., Gosling, J. A., Thorndike, F. P., Ritterband, L. M., & Griffiths, K. M. (2017). Trajectories of change and long-term outcomes in a randomised controlled trial of internet-based insomnia treatment to prevent depression. British Journal of Psychiatry Open, 3(5), 228-235.
(12) Chow, P. I., Ingersoll, K., Thorndike, F. P., Lord, H. R., Gonder-Frederick, L., Morin, C. M., & Ritterband, L. M. (2017). Cognitive Mechanisms of Sleep Outcomes in a Randomized Clinical Trial of Internet-Based Cognitive Behavioral Therapy for Insomnia. Sleep Medicine.

User ratings

User ratings and comments are moderated in order to assure the quality of the submissions. It might take a week for your rating to show up.

Your rating

Login to rate this service.

Other user ratings

No ratings for this service yet.

Last Updated: June 8th 2018