Good results in treatment for insomnia at occupational health services
A study in SalWe’s Mind and Body programme examined the suitability of cognitive-behavioural group treatment of insomnia among workers with different working times. The research established that group treatment reduced the perceived severity and symptoms of insomnia as well as the psychic and somatic signs. The Finnish Institute for Occupational Health has used the results to produce a guide to treating sleeplessness.
Symptoms of sleeplessness are common. Ten percent of people have chronic insomnia and as many as 38 percent of Finns have difficulty sleeping at least three nights a week.
Lack of sleep results in detrimental daytime fatigue, psychological stress and physical symptoms. Over the longer term, insomnia has been found to increase the risk of depression and anxiety disorders. Recent studies have also linked it to hypertension and greater risk of diabetes and mortality.
Poor work performance, sick leave and disability pensions associated with insomnia impose economic costs. International studies indicate that the costs of absenteeism and occupational health services may even be twice as high for insomniacs.
In recent years treatment strategies have emphasised non-pharmacological care, especially for chronic insomnia. International studies into cognitive-behavioural treatment for sleeplessness have shown good long-term results, even when monitored for several years.
The fundamental idea of cognitive-behavioural treatment is to promote sleep by modifying sleeping habits and lifestyle, changing cognitive and emotional patterns and controlling stimuli that interfere sleeping.
Studying broadcasting employees
The suitability of cognitive behavioural group treatment for insomnia, provided by occupational health services, was studied in a joint project between the Finnish Institute of Occupational Health (FIOH) and the Finnish Broadcasting Company (YLE). An FIOH working group was in charge of the study plan, designed the treatment and trained the occupational health workers. The study was part of SalWe’s Mind and Body programme.
“The subjects were chosen from the YLE payroll on the basis of occupational health assessments. Thirty-three had regular daytime hours and 26 had irregular shifts. Treatment was carried out in 2008–2010 in nine groups led by occupational healthcare nurses,” says Heli Järnefelt, an FIOH psychologist of the project.
The insomnia symptoms of the participants and possible consequences of sleeplessness were evaluated twice before the treatment began, immediately after it and then after three, six, 12, 24 and 36 months. Monitoring ceased at the end of 2013.
The study measured insomnia using a sleep diary, an actigraph and questionnaires.
Unambiguous results
There have been relatively few studies, in Finland or abroad, of the suitability of cognitive-behavioural treatment in general and occupational health care, and the strategy has not been used much in Finland. This was pioneering research into developing and studying treatment models for insomnia suitable for occupational health services. It was also the first study of the suitability of group treatment of this kind for irregular shift workers.
“It yielded clear evidence that cognitive-behavioural group treatment is suitable for occupational health services and can produce positive results in treatment of insomnia,” says Heli Järnefelt.
Group treatment led by trained nurses of occupational health services significantly alleviated the symptoms of the working-age participants who were suffering from chronic insomnia. It eased the discomfort they experienced, altered thought patterns harmful to sleep, and reduced psychic and somatic symptoms. Many improvements were maintained after treatment ended. Subjects with regular daytime hours and irregular shifts experienced similar results.
Occupational health guidebook
The FIOH has published a guide to treating insomnia among people of working age, based on the methods used in the study. The book, in Finnish, can be ordered online.
The Institute also trains occupational health workers in evaluating and treating insomnia.
SalWe’s support was particularly important for follow-up monitoring and for detailed analysis and reporting of the study data.
More information
Heli Järnefelt
specialized psychologist
FIOH
heli.jarnefelt@ttl.fi
tel. +358 30 474 2122
