Exploring a Behavioural Therapy for Insomnia in Shift Workers

Abstract

Introduction: About 30% of the Canadian workers population works on shift. It has been reported that 14 to 32% of night shift workers and 8 to 26% of rotating shift workers suffer from Shift Work Sleep Disorder (SWSD). Insomnia is a main symptom of SWSD. Current interventions to treat SWSD consist of pharmacological and light therapies. Only a few behavioural treatments, such as naps, exist to treat this population. This study explores the feasibility and clinical utility of sleep restriction therapy for insomnia in a group of night shift workers. Methods: Six participants meeting SWSD criteria according to ICSD-II were recruited (mean age = 45.7 years old SD = 8,2; 3 women). A multiple baseline design was used. After baseline, each participant received six to eight weekly treatment sessions. They wore an actigraph and completed a daily sleep diary throughout the experimentation. For each sleep period (diurnal sleep, nocturnal sleep), total sleep time (TST), total wake time (TWT), wake after sleep onset (WASO), sleep onset latency (SOL), and sleep eficiency (SE) were calculated from both devices. Results: Times series analyses of sleep diaries data showed that SE increased from baseline to post-treatment for all participants for both diurnal and nocturnal sleep periods. Diurnal sleep SE increased by an average of 10.1% while nocturnal sleep SE increased by 22.1%. TST increased by 25.4 minutes during diurnal sleep for 3 participants while it increased by 57.5 minutes during nocturnal sleep for 5 participants. SOL decreased by 10 minutes in nocturnal sleep while WASO decreased for diurnal and nocturnal sleep by 15.0 and 51.0 minutes respective. ly Conclusion: Our study suggests that sleep restriction therapy is feasible, well accepted, and could improve sleep in night shift workers suffering from SWSD. More studies are warranted to understand and treat insomnia with behavioural interventions in the context of shift work.