Better Sleep, Better Mental Health: Testing a Digital Therapy Program for Workers

Insomnia affects about 10% of the general population, but its impact extends far beyond tossing and turning at night. For workers, poor sleep is linked to accidents, absenteeism, reduced productivity, and higher rates of sick leave. In the UK alone, insomnia costs the economy approximately £50 billion annually, a figure projected to rise to £60 billion by 2030.

Now, researchers have tested whether a digital therapy program delivered through workplaces could effectively address both sleep problems and the emotional difficulties that often accompany them.

A Hybrid Approach to Treatment

The study involved 159 employed adults who were struggling with at least mild insomnia plus symptoms of depression or anxiety. About three quarters were women, with an average age of 44 years. Participants were randomly assigned to either receive an eight week digital intervention immediately or join a waitlist control group.

The intervention combined cognitive behavioral therapy for insomnia with emotion regulation techniques. Participants accessed weekly content on a web based platform, completing about an hour of material each week. Additionally, they attended four video conferencing sessions with trained therapists over the eight week period.

The program addressed multiple aspects of sleep problems. Behavioral components included sleep restriction therapy and stimulus control. Cognitive elements helped participants identify and reframe unhelpful thinking patterns. Educational content covered sleep science and healthy sleep habits. Emotion regulation skills taught relaxation and acceptance techniques.

Participants tracked their sleep using both electronic devices worn on the wrist (actigraphy) and daily sleep diaries. This information helped pace the intervention delivery and monitor progress.

Significant Improvements Across Mental Health Measures

The results were striking. The intervention group showed substantial improvements in insomnia, depression, and anxiety compared to the waitlist control group. These weren't small changes but rather large effect sizes that exceeded what researchers typically see in digital mental health interventions.

Specifically, 45% of participants in the intervention group who had clinical levels of insomnia at the start no longer met those criteria after eight weeks. By contrast, only 3% of the control group showed similar improvement. For depression, about 30% of the intervention group moved from clinical to non clinical levels, compared to just 3% of controls. Anxiety showed a similar pattern, with 30% remission in the intervention group versus 10% in controls.

The improvements in depression and anxiety were particularly noteworthy because they exceeded what researchers usually observe in digital programs specifically designed to treat these conditions. This suggests that addressing sleep problems may tackle a fundamental driver of mental health difficulties.

The Sleep Perception Puzzle

Interestingly, the study revealed a common discrepancy in sleep research. Participants' self reported sleep quality improved dramatically, but objective measurements from wrist worn devices showed less clear changes. This gap appears frequently in sleep studies and highlights how different measurement methods capture different aspects of the sleep experience.

Self reports reflect how people perceive their sleep, which is heavily influenced by their subjective experience of restlessness, worry, and distress. Meanwhile, actigraphy devices measure movement and can sometimes misclassify quiet wakefulness as sleep, particularly in people with insomnia who may lie very still despite being awake.

From a clinical perspective, the subjective experience matters enormously because it drives how distressed people feel and whether they seek treatment. The fact that participants felt they were sleeping better and experiencing less insomnia related distress represents meaningful improvement, regardless of what the devices measured.

Additionally, the intervention did what cognitive behavioral therapy for insomnia is designed to do: it improved sleep efficiency (the percentage of time in bed actually spent asleep) by reducing time spent awake. However, total sleep duration remained largely unchanged at around six and a half hours. This outcome aligns with prior research showing that this type of therapy primarily enhances sleep quality and efficiency rather than substantially increasing how long people sleep.

Work Outcomes Remained Unchanged

Despite improvements in sleep and mental health, the study did not find significant changes in work productivity, job satisfaction, or quality of life measures. The researchers suggest that eight weeks may be too short for improvements in sleep and emotional regulation to translate into measurable workplace benefits. These effects might emerge over longer periods, something future research with extended follow up periods could explore.

High Engagement and Low Dropout

One of the most encouraging findings was the excellent retention rate. Only 15% of participants dropped out by the end of the eight week program, far better than the 40% dropout rates often reported in digital mental health interventions. Participants in the treatment group completed 73% of the online content and attended an average of three out of four therapy appointments.

Several factors may have contributed to this success. The study took place during the COVID 19 pandemic when many employees were working from home with greater flexibility. The remote format likely reduced barriers to participation. Additionally, the four scheduled therapy appointments provided personal accountability and support, preventing the sense of isolation that purely self guided digital programs can create.

Limitations and Future Directions

The study had some limitations worth noting. The participant sample was heavily weighted toward women and white respondents, which limits how broadly the findings can be applied. The study also used a waitlist control group rather than an active comparison treatment, making it difficult to determine which specific components of the intervention were most effective.

The timing during the pandemic presents both opportunities and challenges for interpretation. While the remote format proved convenient during lockdowns, it remains unclear whether engagement would be similar under normal working conditions.

The researchers also acknowledge that they could not track detailed user engagement with the online platform beyond overall completion rates. Future studies would benefit from more granular data about how participants interacted with different components of the program.

A Scalable Solution for Common Problems

This research demonstrates that a digital hybrid program combining cognitive behavioral therapy for insomnia with emotion regulation techniques can effectively reduce insomnia, depression, and anxiety in working adults. The intervention was delivered by trained but non clinical staff through workplace settings, suggesting it could be scaled beyond traditional mental health services.

The approach addresses a critical gap in mental health care. While cognitive behavioral therapy for insomnia is recommended as the first line treatment for insomnia, access remains limited. Digital delivery through workplaces could help reach the many people struggling with sleep problems and related mental health difficulties who might not otherwise receive evidence based treatment.

For employers concerned about the costs of insomnia in their workforce, this type of program offers a practical intervention. For employees dealing with sleepless nights and the anxiety or low mood that often accompanies them, it provides accessible support that fits into their existing routines.

The improvements in how participants perceived their sleep, even without large changes in objectively measured sleep duration, underscore an important principle: subjective experience matters. If people feel they are sleeping better and experiencing less distress, that represents real and meaningful improvement in their quality of life.

Future research with longer follow up periods will help determine whether these benefits persist over time and whether they eventually translate into improvements in work performance and overall quality of life. Additional studies with more diverse populations will also clarify how broadly effective this approach can be.