Efficacy of a Self-Help Web-Based Recovery Training in Improving Sleep in Workers: Randomized Controlled Trial in the General Working Population

Publikation: Beiträge in ZeitschriftenZeitschriftenaufsätzeForschungbegutachtet

Authors

  • Dörte Behrendt
  • David Daniel Ebert
  • Kai Spiegelhalder
  • Dirk Lehr

BACKGROUND: Sleep complaints are among the most prevalent health concerns, especially among workers, which may lead to adverse effects on health and work. Internet-delivered cognitive behavioral therapy for insomnia (iCBT-I) offers the opportunity to deliver effective solutions on a large scale. The efficacy of iCBT-I for clinical samples has been demonstrated in recent meta-analyses, and there is evidence that iCBT-I is effective in the working population with severe sleep complaints. However, to date, there is limited evidence from randomized controlled trials that iCBT-I could also be an effective tool for universal prevention among the general working population regardless of symptom severity. Although increasing evidence suggests that negatively toned cognitive activity may be a key factor for the development and maintenance of insomnia, little is known about how iCBT-I improves sleep by reducing presleep cognitive activity. OBJECTIVE: This study aimed to examine the efficacy of a self-help internet-delivered recovery training, based on principles of iCBT-I tailored to the work-life domain, among the general working population. General and work-related cognitive activities were investigated as potential mediators of the intervention's effect. METHODS: A sample of 177 workers were randomized to receive either the iCBT-I (n=88) or controls (n=89). The intervention is a Web-based training consisting of six 1-week modules. As the training was self-help, participants received nothing but technical support via email. Web-based self-report assessments were scheduled at baseline, at 8 weeks, and at 6 months following randomization. The primary outcome was insomnia severity. Secondary outcomes included measures of mental health and work-related health and cognitive activity. In an exploratory analysis, general and work-related cognitive activities, measured as worry and work-related rumination, were investigated as mediators. RESULTS: Analysis of the linear mixed effects model showed that, relative to controls, participants who received iCBT-I reported significantly lower insomnia severity scores at postintervention (between-group mean difference -4.36; 95% CI -5.59 to - 3.03; Cohen d=0.97) and at 6-month follow-up (between-group difference: -3.64; 95% CI -4.89 to -2.39; Cohen d=0.86). The overall test of group-by-time interaction was significant (P<.001). Significant differences, with small-to-large effect sizes, were also detected for cognitive activity and for mental and work-related health, but not for absenteeism. Mediation analysis demonstrated that work-related rumination (indirect effect: a1b1=-0.80; SE=0.34; 95% boot CI -1.59 to -0.25) and worry (indirect effect: a2b2=-0.37; SE=0.19; 95% boot CI -0.85 to -0.09) mediate the intervention's effect on sleep. CONCLUSIONS: A self-help Web-based recovery training, grounded in the principles of iCBT-I, can be effective in the general working population, both short and long term. Work-related rumination may be a particularly crucial mediator of the intervention's effect, suggesting that tailoring interventions to the workplace, including components to reduce the work-related cognitive activity, might be important when designing recovery interventions for workers. TRIAL REGISTRATION: German Clinical Trials Register DRKS00007142; https://www.drks.de/DRKS00007142.

OriginalspracheEnglisch
Aufsatznummere13346
ZeitschriftJournal of Medical Internet Research
Jahrgang22
Ausgabenummer1
Anzahl der Seiten18
ISSN1439-4456
DOIs
PublikationsstatusErschienen - 07.01.2020

Bibliographische Notiz

Funding Information:
The European Union funded this study, project number: EFRE: CCI 2007DE161PR001. The authors thank Hanne Horvath, who was considerably involved in the development of the training and evaluation.

Publisher Copyright:
© 2020 Journal of Medical Internet Research. All rights reserved.

Dokumente

DOI

Zuletzt angesehen

Publikationen

  1. Real fake? Appropriating mobility via Schengen visa in the context of biometric border controls
  2. HySQA: Hybrid Scholarly Question Answering
  3. ETL ensembles for chunking, NER and SRL
  4. Cross-level Information and Influence in Mandated Participatory Planning: Alternative Pathways to Sustainable Water Management in Germany’s Implementation of the EU Water Framework Directive
  5. Optimisation of root traits to provide enhanced ecosystem services in agricultural systems
  6. Preference and willingness to pay for meat substitutes based on micro-algae
  7. Organizational Practices for the Aging Workforce
  8. Halb voll oder halb leer?
  9. The promise and Pitfalls of a blended, video- and coaching-based professional development program in Germany
  10. Design It!
  11. University mathematics students’ use of resources: strategies, purposes, and consequences
  12. Environmental heterogeneity modulates the effect of plant diversity on the spatial variability of grassland biomass
  13. 2. Advent
  14. Discussion report part 1
  15. Effect of laser peen forming process parameters on bending and surface quality of Ti-6Al-4V sheets
  16. Integration of material flow management tools in workplace environments
  17. Measuring plant root traits under controlled and field conditions
  18. The dependency of the banks’ assets and liabilities
  19. Teaching pragmatic competence with corpora: Intensification in expressions of gratitude across varieties
  20. Zum Begriff der Repräsentation
  21. Counteracting electric vehicle range concern with a scalable behavioural intervention
  22. Introduction
  23. Index und Irritation
  24. Effects of gadolinium and neodymium addition on young’s modulus of magnesium-based binary alloys
  25. Towards a global understanding of tree mortality
  26. Determiner Ellipsis in Electronic Writing - Discourse or Syntax?
  27. Water quantity and quality in the Zerafshan river basin - only an upstream riparian problem?
  28. Digital Design Strategies
  29. Integrated driver rostering problem in public bus transit
  30. Quantifying ecosystem services of rewetted peatlands − the MoorFutures methodologies
  31. I Am Not A Hacker
  32. Analysis of life cycle datasets for the material gold
  33. Species loss due to nutrient addition increases with spatial scale in global grasslands
  34. Wie Jugendliche schreiben
  35. Integrated reporting with CSR practices