Therapist-Directed VS Online Therapy for Insomnia Co-Occuring With Sleep Apnea

Inclusion Criteria: To be included participants must \> 21 years old and: 1. have a diagnosis of OSA with an AHI \> 5 on a diagnostic polysomnogram; 2. accept PAP as primary/sole OSA therapy, been given a prescription for PAP and filled it within the last 3 months, have had an opportunity to use PAP for at least one month, and show mean use of \> 1 hour per night; 3. have a complaint of persistent (i.e., \> 3 months) sleep onset or sleep maintenance difficulties despite having adequate opportunity for sleep and accompanied by significant daytime impairment or distress about poor sleep; 4. an Insomnia Severity Index (ISI) score \> 10 indicating at least "mild" insomnia; and 5. a sleep onset latency or wake time after sleep onset \> 30 minutes 3 or more nights per week during two weeks of sleep diary monitoring. Exclusion Criteria: 1. an untreated psychiatric disorder (e.g., major depression) found on structured interviews as these conditions have specific treatments and it would be inappropriate not to offer those treatments; 2. a lifetime diagnosis of any psychotic or bipolar disorder as sleep restriction for insomnia may precipitate hallucinations and mania; 3. an imminent risk for suicide; 4. alcohol or drug abuse within the past year; 5. terminal illness (e.g., cancer), or neurological degenerative disease (e.g., dementia); 6. current use of medications known to cause insomnia (e.g., stimulants); 7. comorbid narcolepsy, idiopathic hypersomnia, restless legs syndrome (score of \>11 in the IRLS), periodic limb movement during sleep (known PLMS with arousal \> 15 per hour), or a circadian rhythm sleep disorder if habitual bedtimes are later than 3:00 AM or rising times are later than 11:00 AM; or 8. consuming \> 2 alcoholic beverages per day on a regular basis; or 9. consuming more than 10 caffeinated beverages per day on a regular basis; or 10. consuming marijuana in any form on a regular basis \>1 time per week, or if used after 4:00 p.m; or 11. change in thyroid medication dosage or received a new prescription for thyroid medication 3 months before the screening visit; or 12. physician-diagnosed or self-reported seizure disorder.