Comparing Telehealth-Delivered CBT-I to Web-Based CBT-I to Enhance Sleep, Reduce Fatigue, and Promote Neuroprotection

Eligibility Criteria

• * 18-65 years old
• * Diagnosis of relapsing-remitting or secondary progressive MS based on established guidelines21 and verified by their neurologist
• * Mild-to-moderately severe disability (≤ 6 on Patient Determined Disability Steps (PDDS) scale)
• * Report of difficulty falling asleep, maintaining sleep, or waking up too early at least 3 nights/week for the past 3 months with significant distress and impact on function despite adequate opportunity for sleep and not due to other sleep disorders as indicated in the DSM-5
• * ≥10 on Insomnia Severity Index
• * English speaking
• * ≥31 on Telephone Interview of Cognitive Status
• * Has a high school diploma or equivalent to serve as a proxy measurement of reading ability to ensure adequate reading ability to participate in the study
• * Report having access to internet service or a data plan and access to a computer, tablet, or smart phone
• * Known untreated sleep disorder (such as sleep apnea or restless legs syndrome)
• * \>3 on STOP BANG indicating increased risk of sleep apnea
• * Restless legs syndrome as determined by RLS-Diagnosis Index
• * Circadian rhythm sleep-wake disorder as determined by the Sleep Disorders-Revised
• * Parasomnia as determined by the Sleep Disorders-Revised
• * If taking benzodiazepines, non-benzodiazepines, or melatonin supplements or agonists for insomnia, taking \< 3 months or dose has changed in past 3 months
• * Score of ≥20 on the Patient Health Questionnaire (PHQ-9) indicating severe depression or endorsement of suicidal ideation (answer 1, 2 or 3 on #9 of the PHQ-9)
• * Score of ≥15 on the Generalized Anxiety Disorder (GAD-7) indicating severe anxiety
• * Current or history (up to 2 years) of alcohol or drug or alcohol abuse as indicated by DSM-5 criteria
• * History of other nervous system disorder such as stroke or Parkinson's disease
• * Currently pregnant or intending to become pregnant in the next 6 months
• * Severe mental illness such as schizophrenia or bipolar disorder
• * Severe neurological or sensory impairments that would interfere significantly with testing
• * Relapse and/or corticosteroid use in the past 8 weeks
• * History of (within 5 years) or currently conducting overnight shift work including hours of midnight-4am
• * Currently receiving a behavioral sleep health intervention