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.

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Publisher: Elsevier Science Publishers
Document Type: Report; Brief article
Length: 387 words

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Keywords Insomnia; Cognitive behavior therapy; Mediation; Work; Activities of daily living Highlights * Insomnia impairs daytime functioning at work and in activities outside of work. * Change in insomnia mediates modest but important improvements in functioning. * Future versions of digital CBT-I might expand to target daytime functioning. 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. Author Affiliation: (a) Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway (b) Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway (c) Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway (d) Department of Research and Innovation, Helse-Fonna HF, Haugesund, Norway (e) Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK * Corresponding author. Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Østmarkveien 15, 7040, Trondheim, Norway. Article History: Received 12 January 2022; Revised 23 March 2022; Accepted 24 March 2022 Byline: Kaia Kjørstad [kaia.kjorstad@ntnu.no] (a,*), Børge Sivertsen (a,c,d), Øystein Vedaa (a,b,c), Knut Langsrud (a,b), Daniel Vethe (a,b), Patrick M. Faaland (a,b), Cecilie L. Vestergaard (a,b), Stian Lydersen (a), Otto R.F. Smith (c), Jan Scott (a,e), Håvard Kallestad (a,b)

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Gale Document Number: GALE|A703074264