CCATClinical Analysis Tool
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abstractpubmed· abstract· item 41825236

OBJECTIVES: Insomnia is highly prevalent in the workforce and impairs productivity. Cognitive behavioral therapy for insomnia (CBT-I) is the gold-standard treatment but has limited scalability. Digital CBT-I (dCBT-I) offers scalable alternative, yet its effects on workplace productivity are not well established. This study investigated whether dCBT-I produces significant and occupationally meaningful improvements in productivity. METHODS: This study is a secondary analysis of a RCT (clinicaltrials.gov: NCT02988375) with 444 employed adults with DSM-5 insomnia disorder and no other sleep disorders were included (245 in dCBT-I, 199 in sleep education). The Work Productivity and Activity Impairment questionnaire, adapted to a specific health problem with insomnia as the health problem (WPAI-SHP), assessed productivity outcomes. A mixed-effects model evaluated changes in productivity via total work impairment (the primary outcome). Logistic regressions tested the odds of achieving occupationally meaningful improvements (reductions of ≥15% in total work impairment, ≥10% in presenteeism, and ≥5% in absenteeism). RESULTS: Participants receiving dCBT-I demonstrated significantly greater reductions in total work impairment than controls at post-treatment (between-group difference = 16.5 percentage points, 95% CI [11.2, 21.8], p < .001). The odds of achieving a 15% reduction in total work impairment were higher in the dCBT-I group (OR = 2.7 95% CI [1.7, 4.3]). CONCLUSIONS: dCBT-I produced significant improvements in workplace productivity with estimated annual productivity savings of $12,376 per employee. These findings suggest dCBT-I may provide a cost-effective strategy to improve workforce health and productivity, supporting investment in digital mental health tools by employers and health systems.