Articlehybrid2019

Cognitive behavioural therapy interventions for insomnia among shift workers: RCT in an occupational health setting

Heli Järnefelt · Mikko Härmä · Mikael Sallinen · Jussi Virkkala · Teemu I. Paajanen · Kari-Pekka Martimo +1 more

37 citations0/0 files storedInternational Archives of Occupational and Environmental Health

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Abstract

INTRODUCTION: The aim of the study was to compare the effectiveness of cognitive behavioural therapy interventions for insomnia (CBT-I) to that of a sleep hygiene intervention in a randomized controlled design among shift workers. We also studied whether the features of shift work disorder (SWD) affected the results. METHODS: A total of 83 shift workers with insomnia disorder were partially randomized into a group-based CBT-I, self-help CBT-I, or sleep hygiene control intervention. The outcomes were assessed before and after the interventions and at 6-month follow-up using questionnaires, a sleep diary, and actigraphy. RESULTS: Perceived severity of insomnia, sleep-related dysfunctional beliefs, burnout symptoms, restedness, recovery after a shift, and actigraphy-based total sleep time improved after the interventions, but we found no significant differences between the interventions. Mood symptoms improved only among the group-based CBT-I intervention participants. Non-SWD participants had more mental diseases and symptoms, used more sleep-promoting medication, and had pronounced insomnia severity and more dysfunctional beliefs than those with SWD. After the interventions, non-SWD participants showed more prominent improvements than those with SWD. CONCLUSIONS: Our results showed no significant differences between the sleep improvements of the shift workers in the CBT-I interventions and of those in the sleep hygiene control intervention. Alleviation of mood symptoms seemed to be the main added value of the group-based CBT-I intervention compared to the control intervention. The clinical condition of the non-SWD participants was more severe and these participants benefitted more from the interventions than the SWD participants did. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02523079.

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References

1988Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation 2001Validation of the Insomnia Severity Index as an outcome measure for insomnia research 1990Development and validation of the penn state worry questionnaire 2011The Insomnia Severity Index: Psychometric Indicators to Detect Insomnia Cases and Evaluate Treatment Response 1993The rand 36‐item health survey 1.0 2011Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies 2017International Classification of Sleep Disorders 1991The International Classification of Sleep Disorders: Diagnostic and Coding Manual

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2023Effect of cognitive behavioral therapy for insomnia in workers: A systematic review and meta-analysis of randomized controlled trials

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