Effect of cognitive behavioral therapy for insomnia in workers: A systematic review and meta-analysis of randomized controlled trials

Yuta Takano; Rui Ibata; Naho Machida; Ayaka Ubara; Isa Okajima

doi:10.1016/j.smrv.2023.101839

Effect of cognitive behavioral therapy for insomnia in workers: A systematic review and meta-analysis of randomized controlled trials

Sleep Med Rev. 2023 Oct:71:101839. doi: 10.1016/j.smrv.2023.101839. Epub 2023 Aug 22.

Authors

Yuta Takano¹, Rui Ibata², Naho Machida³, Ayaka Ubara⁴, Isa Okajima⁵

Affiliations

¹ Department of Somnology, Tokyo Medical University, Tokyo, Japan; Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan. Electronic address: takano.yuta.3z@tokyo-med.ac.jp.
² Graduate School of Psychological Science, Health Sciences University of Hokkaido, Hokkaido, Japan; Goryokai Medical Corporation, Hokkaido, Japan.
³ Osaka Counseling Center Bellflower, Osaka, Japan.
⁴ PRA Health Sciences K.K., Tokyo, Japan.
⁵ Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan.

PMID: 37657127
DOI: 10.1016/j.smrv.2023.101839

Abstract

Although cognitive behavioral therapy for insomnia (CBT-I) is recommended as a first-line treatment, its efficacy for workers with insomnia remains unclear. This systematic review and meta-analysis aimed to determine the effectiveness of CBT-I in the management of insomnia symptoms in workers. We searched the literature in three electronic databases, namely PubMed, PsycINFO, and Embase, and included 21 studies in the meta-analysis. Compared with the control group, CBT-I overall resulted in significant improvements in terms of severity of insomnia (g = -0.91), sleep onset latency (g = -0.62), wakefulness after sleep onset (g = -0.60), early morning awakening (g = -0.58), and sleep efficiency (g = 0.71). However, there was no improvement in the total sleep time relative to that in the control group. Furthermore, CBT-I significantly alleviated depressive (g = -0.37) and anxiety (g = -0.35) symptoms and fatigue (g = -0.47) compared with the control group. Our study findings suggest that both web-based and face-to-face CBT-I are effective interventions for managing insomnia symptoms in daytime workers, although it is important to note that only face-to-face CBT-I achieved clinically meaningful changes. The effectiveness of CBT-I for shift workers could not be determined.

Keywords: Cognitive behavioral therapy; Insomnia; Mental health; Occupational health; Sleep initiation and maintenance disorder.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Cognitive Behavioral Therapy* / methods
Humans
Randomized Controlled Trials as Topic*
Sleep Initiation and Maintenance Disorders* / therapy