A1 Journal article (refereed)
Cognitive behavioural therapy interventions for insomnia among shift workers : RCT in an occupational health setting (2020)

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

JYU authors or editors

Publication details

All authors or editors: Järnefelt, Heli; Härmä, Mikko; Sallinen, Mikael; Virkkala, Jussi; Paajanen, Teemu; Martimo, Kari-Pekka; Hublin, Christer

Journal or series: International Archives of Occupational and Environmental Health

ISSN: 0340-0131

eISSN: 1432-1246

Publication year: 2020

Volume: 93

Issue number: 5

Pages range: 535-550

Publisher: Springer

Publication country: Germany

Publication language: English

DOI: https://doi.org/10.1007/s00420-019-01504-6

Publication open access: Openly available

Publication channel open access: Partially open access channel

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/68131


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.
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.
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.
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.

Keywords: sleep disorders; insomnia; cognitive behavioural therapy; self-help (psychology); shift work; occupational health

Free keywords: insomnia; cognitive behavioural therapy for insomnia; self-help; sleep hygiene education; shift work; shift work disorder; occupational health services

Contributing organizations

Ministry reporting: Yes

Reporting Year: 2020

JUFO rating: 1

Last updated on 2021-25-08 at 12:41