title: Cognitive behavior therapy for chronic insomnia in occupational health services.
abstract: BACKGROUND
  The aim of this study was to examine the implementation and effectiveness of a cognitive behavioral group intervention model for chronic insomnia (CBT-I) in occupational health services (OHS). We also studied if insomnia symptoms and intervention effects differed on work days and days off.
  
  
  METHODS
  The study design was a non-randomized group intervention, including a waiting period prior to CBT as a control condition. We followed up the results for a period of 6 months. Outcomes were assessed using a sleep diary, questionnaires, and actigraphy. The CBT-I groups were led by trained OHS nurses.
  
  
  RESULTS
  A total of 26 participants completed the study. The intervention improved significantly participants' different self-reported sleep variables, perceived severity of insomnia, sleep-related dysfunctional cognitions, and psychiatric and somatic symptoms. The effects lasted, and partly increased during the follow-up. The participants generally slept significantly better on days off than on work days, but the treatment improved sleep on both.
  
  
  CONCLUSIONS
  The study showed that a non-pharmacological treatment of insomnia can be implemented into OHS with a reasonable amount of effort and that the treatment delivered by trained OHS nurses yields promising results. These findings, however, need to be interpreted cautiously, due to the non-randomized design and small sample size.
authors.affiliation: Finnish Institute of Occupational Health (FIOH), Topeliuksenkatu 41 a A, 00250, Helsinki, Finland. heli.jarnefelt@ttl.fi
authors.forename: Heli
authors.initials: H
authors.lastname: Järnefelt
authors.forename: Rea
authors.initials: R
authors.lastname: Lagerstedt
authors.forename: Soili
authors.initials: S
authors.lastname: Kajaste
authors.forename: Mikael
authors.initials: M
authors.lastname: Sallinen
authors.forename: Aslak
authors.initials: A
authors.lastname: Savolainen
authors.forename: Christer
authors.initials: C
authors.lastname: Hublin
mesh_terms: D056044:Actigraphy; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009786:Occupational Health Services / Q000458:organization & administration; D011615:Psychotherapy, Group; D011788:Quality of Life; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult