CHANGING RECREATIONAL ACTIVITIES FOR REDUCING INSOMNIA SEVERITY? RESULTS FROM A SERIAL MEDIATION ANALYSIS ON THE IMPACT OF RECREATIONAL BEHAVIOR AS A MECHANISM OF CHANGE IN DIGITAL INTERVENTIONS FOR INSOMNIA

Background
Work-related stress is a risk-factor for insomnia.There is metanalytic evidence for insomnia to be a risk factor for and a comorbid condition to various mental and physical conditions.
While insomnia is highly prevalent, first line treatment is not widely available.Recently, there is growing evidence for digital intervention to be effective in different groups including the general working
population.
Purpose
GET.ON-Recovery is a digital intervention with 6 weekly sessions based on cognitive-behavioral-therapy for insomnia and adapted to the needs of employees.The adaptation follows a theoretical framework assuming behavioral change in recreational activities facilitating mental detachment from work-related stressors that in turn affects sleep quality.
While there is evidence for the efficacy of the intervention, the proposed underlying mechanism is unknown.
Method
A serial mediation analysis with individual data pooled from three randomized-controlled trials (N = 433) was conducted to test the proposed mechanism of GET.ON-Recovery.
Results
The intervention led to an increase in both mediators, recreational activities (a1 = 5.75 (3.72–8.18)) and mental detachment (a2 = 0.53(0.38–0.68)).
The marked effect on insomnia severity three months after randomization was mediated by an increased frequency of recreational activities (d21 = 0.01(0.01–0.02) and increased mental detachment from work (b2 = -1.17(-1.74- -0.60) at the end of the intervention.
Conclusions
Results suggest that encouraging workers to incorporate more recreational activities into their daily lives is an appropriate way to promote mental detachment from work, which in turn is a good precondition for restful sleep.
This may provide new insights into the mechanisms of action making digital interventions for insomnia in workers effective.