Academic journal article Scandinavian Journal of Work, Environment & Health

Log in and Breathe Out: Internet-Based Recovery Training for Sleepless Employees with Work-Related Strain - Results of a Randomized Controlled Trial

Academic journal article Scandinavian Journal of Work, Environment & Health

Log in and Breathe Out: Internet-Based Recovery Training for Sleepless Employees with Work-Related Strain - Results of a Randomized Controlled Trial

Article excerpt

There is growing evidence of the negative effects of work stress on sleep (1). Problems with restorative sleep are common: chronic insomnia has a 10% prevalence rate in Western industrialized countries (2-4). Impaired sleep is associated with personal distress, diminished general functioning, increased absenteeism and presenteeism and, in turn, high personal and societal costs (5-7). To effectively target sleep problems in a population of stressed employees, it is important to consider recovery research findings. Recovery from work is regarded as an explanatory mechanism in the relation between acute stress reactions and adverse health. It can be defined as the restoration of depleted resources by psychophysiological unwinding after work (8). Recovery from work is well recognized as an essential daily process to balance the strains of work and prevent general ill health (9-10).

There is evidence that successful recovery from work implies three core components which are closely interrelated: (i) restorative sleep which can be perceived as a particularly important process in recovery from work stress because basic resources are restored during sleep, and fatigue subsequently decreases (11-12); (ii) Cognitive detachment from work is positively associated with general well-being, increased job performance and decreased psychological strain (13) and especially important for restorative sleep (8, 14-15). In fact, a deficient mental detachment has been found to mediate the negative relation between work stress and insomnia complaints (16-17); and (iii) Recreational activities are one way of fostering psychological detachment and restorative sleep by abstracting the mind from work-related thoughts (9, 11). In addition, engaging in leisure activities rebuilds regulatory and affective resources (18).

Evidence-based interventions are available that foster each of these three core components separately. For example cognitive behavioral therapy for insomnia (CBT-I) effectively improves sleep (19-20) and behavior activation interventions increase recreational activities (21). Third, as Querstret and Cropley (22) showed in a meta-analytic review, effective interventions exist for reducing rumination and worrying. An attempt was made to tailor such interventions to employees, and a training mainly focusing on psychological detachment from work was successfully investigated in a controlled but not randomized trial showing moderate effect sizes (23).

To the best of our knowledge, occupational health interventions that aim to promote all three core elements of recovery in an integrated manner have not yet been developed and evaluated. Integrating methods that foster all three components in one intervention and focusing it on the specific target group of stressed employees may increase the potential of inducing effective behavioral change (24-25).

Internet-based interventions for common mental and substance-use disorders as well as insomnia are wellstudied in community and clinical samples (eg, 26-27). But less is known regarding their effectiveness in occupational settings among stressed employees (28). Few studies have been effective in reducing stress and depression in workplace settings (eg, 29). Although research on internet-based interventions for workplace settings remains in its infancy, these interventions may offer some advantages to employees such as anonymity and an easy access independent of time and place. Web-based interventions may attract people who do not utilize traditional mental health services (30).

We therefore developed an internet intervention specifically targeted at employees with the aim of overcoming their deficient recovery from work and decreasing their sleep problems. The intervention (GET.ON Recovery) is based on methods to foster the aforementioned three components of successful recovery from work. We hypothesize that GET.ON Recovery will lead to a greater reduction in insomnia complaints at post-test and 6-month follow up compared to a-wait-list control (WLC) condition. …

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