TY - JOUR
T1 - Is cognitive behavioral therapy for insomnia (CBTi) efficacious for treating insomnia symptoms in shift workers? A systematic review and meta-analysis
AU - Reynolds, Amy C.
AU - Sweetman, Alexander
AU - Crowther, Meagan E.
AU - Paterson, Jessica L.
AU - Scott, Hannah
AU - Lechat, Bastien
AU - Wanstall, Sian E.
AU - Brown, Brandon WJ
AU - Lovato, Nicole
AU - Adams, Robert J.
AU - Eastwood, Peter R.
N1 - Funding Information:
HS reports consultancy and/or research support from Re-Time Pty Ltd, Compumedics Ltd, the American Academy of Sleep Medicine Foundation, and Flinders University, outside of the submitted work. AS reports research funding from ResMed, Philips, the NHMRC, Flinders University and The Hospital Research Foundation, and consultancy work for Australian Doctor and Re-Time Pty Ltd, outside of the submitted work. ACR reports research funding from MSD and Carers Australia through the Sleep Health Foundation, Flinders Foundation, Compumedics Ltd, Safework SA, Sydney Trains and Vanda Pharmaceuticals, outside of the submitted work. Dr. Lovato has received competitive research funding and equipment from Philips Respironics and ResMed as part of NHMRC Centre of Research Excellence (GNT 1134954) and Partnership Grant (GNT 2005779) unrelated to the submitted work. Dr Lovato is also named inventor on 3 patents that are outside of the scope of the submitted work.
Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2023/2
Y1 - 2023/2
N2 - Shift workers commonly report insomnia symptoms. Cognitive behavioral therapy for insomnia (CBTi) is the first line treatment for insomnia, however efficacy in shift workers is not well understood. This systematic review and meta-analysis evaluates existing trials of CBTi in shift working populations. A systematic literature search was conducted across seven electronic databases (n = 2120). Fifty-two full-text articles were reviewed and of these, nine studies (across ten publications with a total of 363 participants) were deemed suitable for inclusion. Heterogeneity was considerable between studies, with variability in study design, style and delivery of intervention, and follow-up times. Small sample sizes were common and attrition was high. Some studies modified aspects of CBTi for use in shift workers, while others were limited to psycho-education as part of larger intervention studies. Mean differences (MD) pre and post CBTi were modest for both the insomnia severity index (ISI; MD: -3.08, 95% CI: -4.39, −1.76) and the Pittsburgh sleep quality index (PSQI; MD: -2.38, 95% CI: -3.55, −1.21). Neither difference was of a magnitude considered to reflect a clinically significant improvement. Tailored approaches to CBTi are needed for shift workers to improve efficacy, ideally including co-production with workers to ensure interventions meet this population's needs.
AB - Shift workers commonly report insomnia symptoms. Cognitive behavioral therapy for insomnia (CBTi) is the first line treatment for insomnia, however efficacy in shift workers is not well understood. This systematic review and meta-analysis evaluates existing trials of CBTi in shift working populations. A systematic literature search was conducted across seven electronic databases (n = 2120). Fifty-two full-text articles were reviewed and of these, nine studies (across ten publications with a total of 363 participants) were deemed suitable for inclusion. Heterogeneity was considerable between studies, with variability in study design, style and delivery of intervention, and follow-up times. Small sample sizes were common and attrition was high. Some studies modified aspects of CBTi for use in shift workers, while others were limited to psycho-education as part of larger intervention studies. Mean differences (MD) pre and post CBTi were modest for both the insomnia severity index (ISI; MD: -3.08, 95% CI: -4.39, −1.76) and the Pittsburgh sleep quality index (PSQI; MD: -2.38, 95% CI: -3.55, −1.21). Neither difference was of a magnitude considered to reflect a clinically significant improvement. Tailored approaches to CBTi are needed for shift workers to improve efficacy, ideally including co-production with workers to ensure interventions meet this population's needs.
KW - Insomnia
KW - Occupational health
KW - Occupational health services
KW - Shift work schedule
KW - Sleep initiation and maintenance disorders
UR - https://www.scopus.com/pages/publications/85145584525
U2 - 10.1016/j.smrv.2022.101716
DO - 10.1016/j.smrv.2022.101716
M3 - Review Article
C2 - 36459948
AN - SCOPUS:85145584525
SN - 1087-0792
VL - 67
JO - Sleep Medicine Reviews
JF - Sleep Medicine Reviews
M1 - 101716
ER -