Effect of one-shot cognitive behavioral therapy on insomnia and heart rate variability of health care workers at the time of COVID-19 pandemic: a randomized controlled trial

Author: Babak Amra1, Faranak Ghadiry2, Atefeh Vaezi3, Alireza Nematollahy2, Niayesh Radfar2, Shaghayegh Haghjoo4, Thomas Penzel5, Charles M Morin6
Affiliation: <sup>1</sup> Bamdad Respiratory and Sleep Research Center, Isfahan University of Medical Sciences, Sepahsalar Ave., Sepehr Cross Road, Isfahan, 8166863543, Iran. amrababak@gmail.com. <sup>2</sup> Isfahan University of Medical Sciences, Isfahan, Iran. <sup>3</sup> Cancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. <sup>4</sup> Applied Physiology Research Center, Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran. <sup>5</sup> Interdisciplinary Center of Sleep Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany. <sup>6</sup> Université Laval, École de Psychologie, Pavillon F.A.S., Québec, Québec, G1K 7P4, Canada.
Conference/Journal: Sleep Breath
Date published: 2022 Nov 21
Other: Special Notes: doi: 10.1007/s11325-022-02746-4. , Word Count: 256

The emergence of sleep disturbances in response to major stressful events has been previously documented. Heart rate variability (HRV) is an objective marker that provides insight into autonomic nervous system dynamics. The aim of the present study was to examine the preliminary effectiveness of a one-shot session of cognitive behavioral therapy for insomnia (CBT-I) for frontline healthcare providers with acute insomnia.

This study was conducted from 2020 to 2021 on healthcare workers with insomnia. The healthcare workers were randomly allocated to receive either one-shot cognitive behavioral therapy or routine care. Insomnia severity index (ISI) and heart rate variability were assessed before and 1 month after the interventions.

Among 57 patients (n = 31 in the intervention group and n = 26 in the control group), mean (± SD) age of both groups were 34.6 (± 9.5) and 36.6 (± 6.9), respectively. Most participants in both groups were female (81% and 65% in the intervention and control groups, respectively; p-value = 0.10). Insomnia severity index score decreased in the intervention group from 13.3 to 6.7 (p < 0.001). The change before and after the intervention was significant between the two groups for HF-normalized unit (high-frequency power band [0.15-0.40 Hz] in the normalized unit) and LF/HF (the ratio of low frequency to high frequency). HF-normalized unit increased in the intervention group (35.8 ± 21.5 vs. 45.6 ± 19.8 before and after the intervention, respectively), and decreased in the control group (43.9 ± 16.5 vs. 39.8 ± 18.5, before and after the intervention, respectively).

The findings suggest that a single-shot session of cognitive behavioral therapy for insomnia is effective in managing acute insomnia symptoms in healthcare workers.

Keywords: Behavioral therapy; COVID-19; Insomnia.

PMID: 36414783 DOI: 10.1007/s11325-022-02746-4