An effective insomnia treatment for night-shift workers

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 (Image: Pixabay CC0)
(Image: Pixabay CC0)
Intervention leads to partial or total remission of insomnia in over 90% of people

A team from Laval University has developed a behavioral intervention that improves sleep and mental health in people whose work involves night shifts. The effectiveness of this intervention has just been demonstrated by this team, led by Professor Annie Vallières, in a study published in the Journal of Sleep Research.

"About 1 in 4 people have a schedule that involves working shifts outside the 6 a.m. to 6 p.m. period. It is estimated that 27% of these people suffer from work schedule disorder," points out Annie Vallières , professor at Université Laval’s School of Psychology and researcher at the CERVO research center and the CHU de Québec-Université Laval research center.

These people experience a desynchronization of their circadian rhythm," she continues. They are out of sync with their natural sleep rhythm, resulting in insomnia and sleepiness. Their mental ruminations about sleep exacerbate their condition. The result is a host of physiological problems such as gastrointestinal problems and cardiovascular disease, but also psychological problems such as anxiety, stress and depressive symptoms."

The usual treatments offered to these people involve light therapy lamps to synchronize the circadian rhythm with the work schedule, sleeping pills to counter insomnia, or caffeine to stay alert. "These different approaches may help temporarily, but they don’t solve the problem permanently," says Professor Vallières.

It’s for this reason that the researcher has been working for some years on developing a behavioral approach for these people. "I use approaches developed to treat nocturnal insomnia and adapt them for people who work night shifts and have to sleep during the day. Treatment for work schedule disorder is based on restricting time in bed and gradually increasing it as sleep efficiency improves, adopting fixed periods for daytime sleep, naps and nighttime sleep (on days off), and controlling light stimuli to create dark conditions aimed at circadian rhythm adjustment."

To test the efficacy of this treatment, Professor Vallières and her colleagues recruited 43 people who worked nights and suffered from work schedule disorder. Almost all were nurses or orderlies. They had been working nights for an average of 5 years, and their sleep problems had lasted for 3.5 years.

At the end of the 8-week intervention, the researchers noted a reduction in the daytime insomnia severity index and a 35-40 minute increase in daytime sleep duration. They also noted a reduction in mental ruminations, anxiety and depressive symptoms. These are substantial improvements," comments Professor Vallières. Among those who followed the treatment to the end, 92% experienced partial or total remission of their work schedule disorder."

"Among people who followed the treatment to completion, 92% experienced partial or total remission of the work schedule disorder" - Annie Vallières People who work nights and struggle with daytime insomnia will have to wait a little before they can enjoy the benefits of this intervention. This treatment is not yet available to the general public, but we are working on an online version," says Professor Vallières. Its effectiveness will be evaluated during a pilot project to be carried out this autumn in collaboration with CIUSSS de la Capitale-Nationale and CIUSSS du Nord-de-l’Île-de-Montréal."

The authors of the study, published in the Journal of Sleep Research, are Annie Vallières, Alric Pappathomas, Séverine de Billy Garnier, Chantal Mérette and Célyne Bastien, from Université Laval, Julie Carrier, from Université de Montréal, and Tyna Paquette, from CIUSSS du Nord-de-l’Île-de-Montréal.