Cognitive Behavior Therapy for Chronic Insomnia in Occupational Health Services

• Published in: Journal of occupational rehabilitation Vol. 22; no. 4; pp. 511 - 521
• Main Authors: Järnefelt, Heli, Lagerstedt, Rea, Kajaste, Soili, Sallinen, Mikael, Savolainen, Aslak, Hublin, Christer
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-12-2012; Springer; Springer Nature B.V
• Subjects: Actigraphy; Adult; Aged; Analysis of Variance; Behavior modification; Behavioral health care; Care and treatment; Clinical Psychology; Cognition & reasoning; Cognitive therapy; Cognitive Therapy - methods; Comorbidity; Diaries; Environmental Health; Family physicians; Female; Finland; Follow-Up Studies; Health care industry; Health Psychology; Health services; Health Status; Humans; Insomnia; Intervention; Male; Medicine; Medicine & Public Health; Middle Aged; Nurses; Occupational health; Occupational health services; Occupational Health Services - organization & administration; Occupational Medicine/Industrial Medicine; Occupational therapy; Orthopedics; Physicians; Psychologists; Psychotherapy, Group; Quality of Life; Questionnaires; Rehabilitation; Restless legs syndrome; Severity of Illness Index; Sleep; Sleep Initiation and Maintenance Disorders - diagnosis; Sleep Initiation and Maintenance Disorders - therapy; Studies; Surveys and Questionnaires; Treatment Outcome; Womens health; Work hours; Young Adult; Finland; Occupational health services; Non-pharmacological treatment; Insomnia; Cognitive behavioral therapy
• ISSN: 1053-0487; 1573-3688
• DOI: 10.1007/s10926-012-9365-1

Introduction
The aim of this study was to examine the implementation and effectiveness of a cognitive behavioral group intervention model for chronic insomnia (CBT-I) in occupational health services (OHS). We also studied if insomnia symptoms and intervention effects differed on work days and days off.
Methods
The study design was a non-randomized group intervention, including a waiting period prior to CBT as a control condition. We followed up the results for a period of 6 months. Outcomes were assessed using a sleep diary, questionnaires, and actigraphy. The CBT-I groups were led by trained OHS nurses.
Results
A total of 26 participants completed the study. The intervention improved significantly participants’ different self-reported sleep variables, perceived severity of insomnia, sleep-related dysfunctional cognitions, and psychiatric and somatic symptoms. The effects lasted, and partly increased during the follow-up. The participants generally slept significantly better on days off than on work days, but the treatment improved sleep on both.
Conclusions
The study showed that a non-pharmacological treatment of insomnia can be implemented into OHS with a reasonable amount of effort and that the treatment delivered by trained OHS nurses yields promising results. These findings, however, need to be interpreted cautiously, due to the non-randomized design and small sample size.