Log in and breathe out: internet-based recovery training for sleepless employees with work-related strain – results of a randomized controlled trial

TLDR

The study aimed to evaluate the efficacy of an internet‑based recovery training for employees experiencing work‑related strain and sleep problems. The intervention consisted of six CBT‑I–based lessons delivered online to 128 German teachers with insomnia and work‑related rumination, compared to a wait‑list control, with insomnia severity as the primary outcome. The training produced a large, clinically meaningful reduction in insomnia severity (d = 1.45, NNT < 2) and sustained improvements in sleep, work detachment, and recreational activity at 6 months.

Abstract

Objectives The primary purpose of this randomized controlled trial (RCT) was to evaluate the efficacy of a guided internet-based recovery training for employees who suffer from both work-related strain and sleep problems ( GET.ON Recovery ). The recovery training consisted of six lessons, employing well-established methods from cognitive behavioral therapy for insomnia (CBT-I) such as sleep restriction, stimulus control, and hygiene interventions as well as techniques targeted at reducing rumination and promoting recreational activities. Methods In a two-arm RCT (N=128), the effects of GET.ON Recovery were compared to a waitlist-control condition (WLC) on the basis of intention-to-treat analyses. German teachers with clinical insomnia complaints (Insomnia Severity Index ≥15) and work-related rumination (Irritation Scale, cognitive irritation subscale ≥15) were included. The primary outcome measure was insomnia severity. Results Analyses of covariance (ANCOVA) revealed that, compared to the WLC, insomnia severity of the intervention group decreased significantly stronger (F=74.11, P<0.001) with a d=1.45 [95% confidence interval (95% CI) 1.06–1.84] The number needed to treat (NNT) was <2 for reliable change and NNT <4 for reduction in expert-rated diagnosis of primary insomnia. Conclusion The training significantly reduces sleep problems and fosters mental detachment from work and recreational behavior among adult stressed employees at post-test and 6-months follow up. Given the low threshold access this training could reach out to a large group of stressed employees when results are replicated in other studies.