Online Insomnia Treatment in Australian General Practice

This implementation trial will investigate the feasibility and effectiveness of providing Australian General Practitioners, and general practice patients access to online cognitive and behavioural therapy for insomnia (CBTi), and Royal Australian College of General Practitioner (RACGP) guideline recommendations on 'insomnia' management and 'sleeping pill withdrawal'. We will use existing General Practitioner software to identify three groups of patients, based on recent history of medications commonly prescribed for insomnia (including; Temazepam, Oxazepam, Nitrazepam, Zolpidem, Zopiclone and Melatonin). We will divide patients into those with; 1. New Insomnia - No history of sleeping pills prescribed in the past 12 months, 2. Single Sleeping Pill Prescription - One sleeping pill prescription in the past 12 months 3. Repeat Sleeping Pill Prescriptions - Two or more sleeping pill prescriptions in the past 12 months Online CBTi will be made available to all three groups of patients. Sleepio (www.sleepio.com, Big Health, UK) is a well-established online CBTi program which includes 6-weekly self-administered sessions. Sleepio includes CBTi components; bedtime restriction therapy, stimulus control therapy, sleep hygiene information, relaxation therapy, and cognitive restructuring techniques. Patients may complete daily sleep diaries (3 min) in addition to weekly CBTi sessions (20-30 minutes each). Patients will receive reminder and summary emails to promote adherence throughout the program, however no additional support will be offered to encourage adherence. Via GP software, treating GPs will be sent notifications containing patient-tailored RACGP insomnia management guidelines and sleeping pill withdrawal information. These GP notifications will differ based on the above patient groups; 1. New Insomnia - GPs will receive a notification containing RACGP guidelines and a referral link to online CBTi, 2. Single Sleeping Pill Prescription - GPs will receive a notification containing RACGP guidelines, printable sleeping pill withdrawal fact sheets and tapering schedules, and a referral link to online CBTi, and 3. Repeat Sleeping Pill Prescriptions - GPs will receive a notification containing RACGP guidelines, printable sleeping pill withdrawal fact sheets and tapering schedules, and a referral link to online CBTi.