title: Log in and breathe out: efficacy and cost-effectiveness of an online sleep training for teachers affected by work-related strain--study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Insomnia and work-related stress often co-occur. Both are associated with personal distress and diminished general functioning, as well as substantial socio-economic costs due to, for example, reduced productivity at the work place and absenteeism. Insomnia complaints by people experiencing work-related stress are correlated with a deficient cognitive detachment from work. Diffuse boundaries between work and private life can additionally complicate the use of recreational activities that facilitate cognitive detachment.Cognitive behavioral therapy for insomnia is effective but rarely implemented. Internet-based cognitive behavioral therapy for insomnia could potentially reduce this deficit given its demonstrated effectiveness. Less is known, however, about the efficacy of internet-based cognitive behavioral therapy for insomnia in populations affected by high work stress. Thus, the aim of the present study is to evaluate the efficacy and cost-effectiveness of a newly developed, guided online training which is based on Cognitive Behavioral Therapy for insomnia and tailored to teachers affected by occupational stress.
  
  
  METHODS
  In a two-arm randomized controlled trial (N = 128), the effects of a guided online sleep training will be compared to a waitlist-control condition. German teachers with significant clinical insomnia complaints (Insomnia Severity Index ≥ 15) and work-related rumination (Irritation Scale, subscale Cognitive Irritation ≥ 15) will be included in the study. The primary outcome measure will be insomnia severity. Additionally, an economic evaluation from a societal perspective will be conducted. Data from the intention-to-treat sample will be analyzed two and six months after randomization.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first study to evaluate an online sleep training tailored to a specific population with work stress, that is, teachers. If this type of intervention is effective, it could reduce the paucity of cognitive behavioral therapy for insomnia and augment the support for teachers in coping with their insomnia problems.
  
  
  BACKGROUND
  German Clinical Trial Register (DRKS): DRKS00004700.
authors.affiliation: Innovation Incubator, Division of Health Training Online, Leuphana University Lueneburg, Rotenbleicher Weg 67, 21335 Lueneburg, Germany. thiart@inkubator.leuphana.de
authors.forename: Hanne
authors.initials: H
authors.lastname: Thiart
authors.forename: Dirk
authors.initials: D
authors.lastname: Lehr
authors.forename: David Daniel
authors.initials: DD
authors.lastname: Ebert
authors.forename: Bernhard
authors.initials: B
authors.lastname: Sieland
authors.forename: Matthias
authors.initials: M
authors.lastname: Berking
authors.forename: Heleen
authors.initials: H
authors.lastname: Riper
mesh_terms: D006801:Humans; D000223:Adaptation, Psychological; D015928:Cognitive Behavioral Therapy / Q000191:economics; D003362:Cost-Benefit Analysis; D005178:Faculty; D005858:Germany; D017048:Health Care Costs; D020407:Internet / Q000191:economics; D016272:Occupational Health / Q000191:economics; D010561:Personnel Staffing and Scheduling; D012107:Research Design; D012720:Severity of Illness Index; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D013315:Stress, Psychological / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome; D016526:Workload; D016032:Randomized Controlled Trials as Topic