Cognitive behavioural therapy interventions for insomnia among shift workers : RCT in an occupational health setting
Järnefelt, H., Härmä, M., Sallinen, M., Virkkala, J., Paajanen, T., Martimo, K.-P., & Hublin, C. (2020). Cognitive behavioural therapy interventions for insomnia among shift workers : RCT in an occupational health setting. International Archives of Occupational and Environmental Health, 93(5), 535-550. https://doi.org/10.1007/s00420-019-01504-6
© 2020 the Authors
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. ...
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Additional information about fundingThis study was supported by grants from the Finnish Work Environment Fund (114391), and NordForsk, the Nordic Program on Health and Welfare (74809).
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