Comparison of Tailored Versus Standard Group Cognitive Behavioral Therapy for Shift Worker Insomnia: A Randomized Controlled Trial

Shift workers are at increased risk for insomnia. The standard treatment (cognitive behavioral therapy for insomnia) poses significant challenges for this demographic due to irregular work and sleep schedules. New approaches are still considered insufficient due to high attrition or insufficient effectiveness. Our preliminary study [1] identified sleep-relevant state and trait factors (see secondary outcomes) to incorporate into an innovative manual that addresses sleep in an implicit manner. The objective was to reduce the focus on insomnia and to replace regularity interventions. With a sample of 55 insomniacs (67.74% male, mean age 41.62 years), standard vs. customized treatment were compared at pre-, post-, and 3-month follow-up measurement (RCT, self-assessment data). Linear mixed models revealed significant main effects of the measurement point for the primary (insomnia severity, sleep quality, sleep onset latency, total sleep time, daytime sleepiness) and the secondary outcomes (selection: anxiety/depression, dysfunctional beliefs, arousal, emotional stability, concern). No main effects of the condition or interaction effects were identified. Non-inferiority and equivalence tests demonstrated that the customized treatment is equivalent to standard therapy, which is a favorable outcome in light of the implicit approach. Consequently, this innovative approach warrants further exploration, incorporating the present results.