# The Effects of Digital-Based Cognitive Behavioral Therapy for Insomnia (CBT-I) on Sleep Quality in Shift Workers: A Scoping Review

## TL;DR

Digital CBT-I improves sleep quality for shift workers and is as effective as in-person therapy.

## Contribution

This scoping review evaluates the effectiveness of digital CBT-I for insomnia in shift workers.

## Key findings

- Digital CBT-I improved sleep quality in shift workers, with only one study showing no improvement.
- Digital CBT-I was found to be as effective as in-person CBT-I for sleep quality in shift workers.
- User feedback suggested that customization and individualized feedback could enhance engagement with dCBT-I.

## Abstract

Insomnia, characterized by difficulty falling asleep or staying asleep, is prevalent among shift workers due to irregular work hours. Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for alleviating insomnia symptoms; however, accessibility of CBT-I for shift workers is limited. To increase the user access and usefulness of CBT-I, digital CBT-I (dCBT-I) has attracted growing clinical and research interest in the field. This scoping review examines the effects of dCBT-I on improving sleep quality among shift workers. A comprehensive literature search across multiple databases identified 11 primary studies from 2014 to 2024, encompassing various shift-working populations. The findings were synthesized into themes, including the impacts of dCBT-I on sleep quality, sleep hygiene, objective sleep data, anxiety, depression, quality of life, and user feedback. All studies showed improved sleep quality after the implementation of dCBT-I, except for one. Two studies suggest that dCBT-I is equally effective as in-person delivery of CBT-I in improving sleep quality among shift workers. Per user feedback, incorporating individualized feedback and more customization options in dCBT-I would improve engagement and adherence to the intervention. Collectively, the findings in this review suggest that dCBT-I is an accessible and effective alternative to traditionally delivered CBT-I for improving sleep quality in shift workers.