The effects of a cluster randomized controlled workplace intervention on sleep and work-family conflict outcomes in an extended care setting

Abstract

Objectives To evaluate the effects of a workplace-based intervention on actigraphic and self-reported sleep outcomes in an extended care setting. Design Cluster randomized trial. Setting Extended-care (nursing) facilities. Participants US employees and managers at nursing homes. Nursing homes were randomly selected to intervention or control settings. Intervention The Work, Family and Health Study developed an intervention aimed at reducing work-family conflict within a 4-month work-family organizational change process. Employees participated in interactive sessions with facilitated discussions, role-playing, and games designed to increase control over work processes and work time. Managers completed training in family-supportive supervision. Measurements Primary actigraphic outcomes included: total sleep duration, wake after sleep onset, nighttime sleep, variation in nighttime sleep, nap duration, and number of naps. Secondary survey outcomes included work-to-family conflict, sleep insufficiency, insomnia symptoms and sleep quality. Measures were obtained at baseline, 6-months and 12-months post-intervention. Results A total of 1,522 employees and 184 managers provided survey data at baseline. Managers and employees in the intervention arm showed no significant difference in sleep outcomes over time compared to control participants. Sleep outcomes were not moderated by work-to-family conflict or presence of children in the household for managers or employees. Age significantly moderated an intervention effect on nighttime sleep among employees (p=0.040), where younger employees benefited more from the intervention. Conclusion In the context of an extended-care nursing home workplace, the intervention did not significantly alter sleep outcomes in either managers or employees. Moderating effects of age were identified where younger employees’ sleep outcomes benefited more from the intervention.

Insomnia Interventions in the Workplace: A Systematic Review and Meta-Analysis

“…The results obtained reported increased quality of sleep [ 32 ], an increase of one hour per week in the total sleep time, and an improvement in workers’ perceptions regarding the insufficiency of sleep [ 40 ]. Likewise, it was noted [ 37 ] that these improvements in sleep were statistically more significant among younger workers and in jobs which required a longer physical presence in the workplace.…”

“…Of the interventions involved in this study, the majority produced positive results [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 36 , 38 , 39 , 40 , 41 , 42 , 44 ] ( n = 18) or neutral results [ 35 , 37 , 43 ] ( n = 3) with only one exception, which produced negative results [ 45 ].…”

“…Moreover, an ISI psychometry study revealed that a cut-off score of 10 is acceptable for diagnosing insomnia in community samples. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used in 8 studies [ 32 , 33 , 36 , 37 , 39 , 40 , 42 , 44 ] and a minority of the studies used Ad Hoc [ 26 , 28 ] questionnaires or other scales such as the Athens Insomnia Scale (AIS) [ 36 ] or The Basic Nordic Sleep Questionnaire (BSNQ) [ 29 ] to measure the level of insomnia. The results obtained after using these tools were finalized and contrasted with objective measurements such as actigraphy.…”

“…Of the 22 studies selected, 68.1% were interventions based on cognitive behavioral therapy (CBT) [ 24 , 25 , 27 , 30 , 31 , 33 , 34 , 35 , 36 , 39 , 41 , 43 , 44 , 45 ], 13.6% on health programs [ 32 , 37 , 40 ], 9.1% on mindfulness-based therapies [ 28 , 42 ] or expressive writing [ 38 ], and only one intervention studied the effect of a drug [ 26 ]. The majority of the interventions were carried out through internet-based sessions and the average length of the sessions was around 80 minutes.…”

“…Three studies in particular based their intervention on developing a health program as a way of reducing insomnia levels in workers. Their approaches varied, ranging from the implementation of a physical activity program in the workplace [ 32 ] to steps to promote family reconciliation [ 37 , 40 ]. All the programs were conducted in the workplace itself, with voluntary participation and, in two cases, financial incentives.…”