Struggling to Sleep as You Get Older? UVA Researchers Find Online Therapy Can Help

You go to bed feeling tired, hoping for a good night’s sleep. But instead of drifting off, you find yourself staring at the ceiling.

Or maybe you fall asleep easily, only to wake at 2 or 3 in the morning and spend the next several hours trying to fall back asleep.

For many older adults, this becomes an increasingly familiar experience.

Sleep patterns naturally change with age, but persistent difficulty falling asleep or staying asleep isn’t something people simply have to accept.

Researchers at the University of Virginia have found that a specially designed online therapy program can significantly improve sleep among older adults, with benefits lasting as long as a year after treatment.

The findings offer a promising alternative for people who have difficulty finding a sleep specialist, cannot easily travel to appointments, or would prefer a treatment that doesn’t rely on sleeping pills.

Why Sleep Becomes More Difficult With Age

As people grow older, their sleeping patterns tend to change.

They may fall asleep earlier in the evening, wake earlier in the morning, and spend less time in deep sleep.

Medical conditions, chronic pain, medications, anxiety, and nighttime bathroom trips can also interfere with rest.

According to the National Institute on Aging, insomnia is one of the most common sleep problems among older adults.

Occasionally having trouble sleeping is normal. But chronic insomnia involves persistent difficulty falling asleep, staying asleep, or getting adequate rest, often accompanied by problems functioning during the day.

Poor sleep can lead to fatigue, difficulty concentrating, irritability, and reduced motivation.

For older adults, those problems can make everyday activities more challenging.

Some people become less physically active because they’re exhausted. Others withdraw from social activities or begin worrying about whether they’ll get enough sleep the following night.

That worry can make the problem worse.

A Treatment That Doesn’t Depend on Sleeping Pills

Cognitive behavioral therapy for insomnia, commonly called CBT-I, is considered a first-line treatment for chronic insomnia.

Unlike sleeping medications, CBT-I focuses on changing the thoughts and behaviors that interfere with healthy sleep.

For example, someone who has spent several nights awake may begin associating bedtime with frustration and anxiety.

The more they worry about not sleeping, the harder it becomes to relax.

CBT-I helps interrupt that cycle.

Treatment typically includes learning how to maintain a consistent sleep schedule, changing habits that interfere with rest, reducing excessive time spent awake in bed, and addressing worries about sleep.

It may also involve relaxation techniques and keeping a sleep diary.

The National Institutes of Health says CBT-I usually takes approximately six to eight weeks.

But finding a qualified therapist can be difficult.

Specialists aren’t available in every community, and repeated appointments can become expensive or inconvenient, especially for older adults with transportation or mobility challenges.

That’s where online treatment may help.

UVA Researchers Put Digital Sleep Therapy to the Test

Researchers at the University of Virginia School of Medicine developed an internet-based program specifically designed for older adults experiencing insomnia.

The program is called SHUTi OASIS, short for Sleep Healthy Using the Internet for Older Adults Suffering with Insomnia and Sleeplessness.

It builds on an earlier digital treatment developed by UVA researchers.

In a clinical trial published in npj Digital Medicine in July 2025, researchers enrolled 311 adults aged 55 to 95.

Researchers randomly assigned participants to one of three groups.

One group received the online sleep therapy program. Another used the program with additional support available when needed. A third received conventional sleep education materials online.

Researchers evaluated participants after treatment, six months later, and again at one year.

The results showed that both groups receiving the digital therapy experienced significantly greater improvements in insomnia symptoms than those receiving sleep education alone.

At the one-year follow-up, approximately two to three times as many participants in the treatment groups showed meaningful improvement or remission of insomnia.

Participants also reported improvements in sleep quality, time to fall asleep, and how often they woke during the night.

The results suggest that an internet-based program can provide lasting benefits for some older adults without requiring regular in-person appointments.

Designed With Older Adults in Mind

One reason the study is particularly interesting is that researchers didn’t simply take an existing online program and assume older adults would be comfortable using it.

They made changes to improve accessibility and usability.

The updated program included larger text, improved color contrast, simpler navigation, and shorter instructional videos.

It also provided examples and information more relevant to older adults, including discussions about medications, chronic health conditions, nighttime bathroom visits, and mobility limitations.

Participants completed online sleep diaries and questionnaires that helped the program adjust recommendations to their individual needs.

The treatment was divided into six instructional sections, allowing users to work through the material over several weeks.

Dr. Lee Ritterband, a UVA professor and director of the university’s Center for Behavioral Health & Technology, helped develop the program.

In announcing the findings, Ritterband said nearly one-third of the study participants were 70 or older.

“Not only did we find that this works, but we found that older adults were able to do this with very little, if any, additional help,” he said.

That finding matters because digital healthcare tools aren’t always designed for people with limited experience with technology.

The study suggests that relatively simple design changes can help make these treatments more accessible.

Why Better Sleep Matters Beyond Feeling Rested

Insomnia doesn’t just make people tired the following morning.

Persistent sleep problems can affect concentration, mood, physical activity, and overall quality of life.

Research has also found associations between chronic sleep problems and conditions such as depression, cardiovascular disease, and cognitive difficulties.

However, those relationships are complicated.

Insomnia can occur alongside other health problems, and improving sleep has not been proven to prevent dementia, heart disease, or every other condition associated with poor sleep.

Researchers have shown that effective insomnia treatment can improve sleep and certain measures of daytime functioning and emotional well-being.

Another 2025 analysis involving 315 adults aged 65 and older found that digital CBT-I significantly improved insomnia symptoms and was associated with improvements in depression and anxiety symptoms compared with control groups.

For someone struggling through the day after another sleepless night, those improvements can make a meaningful difference.

What About Sleep Medications?

Sleeping pills can sometimes provide short-term relief, but they are not necessarily the best long-term solution for older adults.

Certain sleep medications can cause next-day drowsiness, confusion, or balance problems.

Some can also increase the risk of falls, particularly among older people taking multiple medications.

For these reasons, medical guidelines generally recommend cognitive behavioral therapy as the first treatment for chronic insomnia.

That doesn’t mean medications are never appropriate.

Treatment decisions depend on the individual’s health, symptoms, and medical history.

Anyone currently taking prescription sleep medication should consult their healthcare provider before changing or stopping it.

How to Find Online Insomnia Treatment

Not every sleep-related website or smartphone app provides evidence-based treatment.

Some applications simply play relaxing music, track sleep, or offer general sleep tips.

Those tools may be useful, but they aren’t necessarily equivalent to structured cognitive behavioral therapy for insomnia.

The UVA program, SHUTi OASIS, was developed and studied as a clinical intervention. Its research results should not be taken to mean that the exact program is freely available to all patients.

Other digital CBT-I treatments are available through healthcare providers, and some require a prescription or have eligibility restrictions.

People interested in online treatment should ask their primary care provider or a sleep specialist about evidence-based CBT-I programs and whether their insurance covers treatment.

It’s also important to rule out other possible causes of poor sleep.

Sleep apnea, restless legs syndrome, medication side effects, and certain medical conditions may require different treatments.

Discuss loud snoring, pauses in breathing during sleep, severe daytime sleepiness, or persistent insomnia with a healthcare professional.

A Better Night’s Sleep Is Still Possible

As we get older, many changes occur, including changes in how we sleep.

But chronic insomnia doesn’t have to become an accepted part of everyday life.

Research from the University of Virginia and other institutions shows that online cognitive behavioral therapy can help older adults improve their sleep without requiring the same access to in-person specialists.

For people who have spent months or years struggling to get a good night’s rest, that offers another option worth exploring.

Sometimes, improving sleep isn’t about finding a stronger sleeping pill.

It’s about learning new ways to approach bedtime, manage sleep habits, and break the cycle that keeps people awake.

And increasingly, that help may be available from the comfort of home.