The effects of digital CBT-I on work productivity and activity levels and the mediational role of insomnia symptoms: Data from a randomized controlled trial with 6-month follow-up

Kaia Kjørstad; Børge Sivertsen; Øystein Vedaa; Knut Langsrud; Daniel Vethe; Patrick M Faaland; Cecilie L Vestergaard; Stian Lydersen; Otto R F Smith; Jan Scott; Håvard Kallestad

doi:10.1016/j.brat.2022.104083

The effects of digital CBT-I on work productivity and activity levels and the mediational role of insomnia symptoms: Data from a randomized controlled trial with 6-month follow-up

Behav Res Ther. 2022 Jun:153:104083. doi: 10.1016/j.brat.2022.104083. Epub 2022 Mar 31.

Authors

Affiliations

¹ Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway. Electronic address: kaia.kjorstad@ntnu.no.
² Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway; Department of Research and Innovation, Helse-Fonna HF, Haugesund, Norway.
³ Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway; Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.
⁴ Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway.
⁵ Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.
⁶ Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.
⁷ Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway; Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.

PMID: 35526432
DOI: 10.1016/j.brat.2022.104083

Abstract

Study objectives: Cognitive behavioral therapy for insomnia (CBT-I) is a well-established treatment for insomnia, but few studies have explored its impact on work and activity impairment.

Methods: Data stem from 1721 participants enrolled in a randomized controlled trial comparing the efficacy of digital CBT-I compared with Patient Education. Baseline and 6-month follow-up assessments included self-reported ratings of presenteeism and general impairment (Work Productivity and Activity Impairment Questionnaire), and absenteeism (hours of missed work) and employment status. Insomnia was measured using the Insomnia Severity Index (ISI). Mediation analyses were conducted for each outcome with ISI scores at baseline and 9-week follow-up as the mediator. The analyses were adjusted for potential confounders (e.g., sex, age, comorbidities).

Results: dCBT-I was found to be associated with reduced activity impairment compared with PE (by 5.6%) but not presenteeism, absenteeism, or changes in employment status. Mediation analysis showed that changes in insomnia severity largely mediated improvements in presenteeism (by 5.4%) and activity impairment (by 5.5%). There were no significant mediational effects on absenteeism or employment status.

Conclusions: This study shows that dCBT-I is not only effective in improving insomnia. But also demonstrates positive effects on work and daily activities in general, supporting the need for increased access to dCBT-I.

Keywords: Activities of daily living; Cognitive behavior therapy; Insomnia; Mediation; Work.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Cognitive Behavioral Therapy*
Follow-Up Studies
Humans
Sleep Initiation and Maintenance Disorders* / therapy
Surveys and Questionnaires
Treatment Outcome