Insomnia Interventions in the Workplace: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Methodology
2.1. Protocol
2.2. Databases and Search Strategy
2.3. Eligibility Criteria
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- Participants: studies carried out on currently employed workers were considered.
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- Intervention/exposure: studies that evaluated interventions aimed at reducing insomnia in workers were considered, either as a primary or secondary outcome measure.
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- Comparison: we also considered studies that compared the results obtained after the intervention on insomnia in workers with results from those workers who, after being recruited from the same population group, did not undergo any intervention, and stayed on the waiting list or continued with their usual activities.
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- Results: any study obtaining primary or secondary results on work-related insomnia were considered.
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- Time: original studies with no restrictions on the date of publication were included.
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- Study design: only randomized controlled trials (RCT) were included.
2.4. Study Selection
2.5. Data Extraction
2.6. Risk of Bias Assessment
2.7. Quality Assessment
2.8. Statistical Analysis
3. Results
3.1. Characteristics of the Studies
3.2. Intervention Protocols
3.2.1. Cognitive Behavioral Therapy
3.2.2. Health Programs
3.2.3. Mindfulness-Based Therapies and Other Therapies
3.3. Risk of Bias in the Studies Included
3.4. Intervention Effects
3.5. Funnel Plot
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
- Baglioni, C.; Altena, E.; Bjorvatn, B.; Blom, K.; Bothelius, K.; Devoto, A.; Espie, C.A.; Frase, L.; Gavriloff, D.; Tuuliki, H.; et al. The European Academy for Cognitive Behavioural Therapy for Insomnia: An initiative of the European Insomnia Network to promote implementation and dissemination of treatment. J. Sleep Res. 2019, e12967. [Google Scholar] [CrossRef] [PubMed]
- American Psychiatric Association. Actualización del DSM-5®; American Psychiatric Association Publishing: Washington, DC, USA, 2016. [Google Scholar]
- Buysse, D.J. Insomnia. JAMA 2013, 309, 706–716. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Riemann, D.; Baglioni, C.; Bassetti, C.; Bjorvatn, B.; Dolenc Groselj, L.; Ellis, J.G.; Espie, C.A.; Garcia-Borreguero, D.; Gjerstad, M.; Gonçalves, M.; et al. European guideline for the diagnosis and treatment of insomnia. J. Sleep Res. 2017, 26, 675–700. [Google Scholar] [CrossRef] [PubMed]
- Bjorvatn, B.; Meland, E.; Flo, E.; Mildestvedt, T. High prevalence of insomnia and hypnotic use in patients visiting their general practitioner. Fam. Pract. 2017, 34, 20–24. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Yang, B.; Wang, Y.; Cui, F.; Huang, T.; Sheng, P.; Shi, T.; Huang, C.; Lan, Y.; Huang, Y.-N. Association between insomnia and job stress: A meta-analysis. Sleep Breath. 2018, 22, 1221–1231. [Google Scholar] [CrossRef]
- Rajaratnam, S.M.W.; Licamele, L.; Birznieks, G. Delayed sleep phase disorder risk is associated with absenteeism and impaired functioning. Sleep Health 2015, 1, 121–127. [Google Scholar] [CrossRef] [PubMed]
- Schlack, R.; Hapke, U.; Maske, U.; Busch, M.; Cohrs, S. Häufigkeit und Verteilung von Schlafproblemen und Insomnie in der deutschen Erwachsenenbevölkerung. Bundesgesundheitsblatt—Gesundheitsforsch—Gesundheitsschutz 2013, 56, 740–748. [Google Scholar] [CrossRef] [Green Version]
- DiBonaventura, M.; Richard, L.; Kumar, M.; Forsythe, A.; Flores, N.M.; Moline, M. The association between insomnia and insomnia treatment side effects on health status, work productivity, and healthcare resource use. PLoS ONE 2015, 10, e0137117. [Google Scholar] [CrossRef]
- Hu, C.-J.; Hong, R.-M.; Yeh, G.-L.; Hsieh, I.-C. Insomnia, Work-Related Burnout, and Eating Habits Affecting the Work Ability of Flight Attendants. Aerosp. Med. Hum. Perform. 2019, 90, 601–605. [Google Scholar] [CrossRef]
- Laugsand, L.E.; Strand, L.B.; Vatten, L.J.; Janszky, I.; Bjørngaard, J.H. Insomnia Symptoms and Risk for Unintentional Fatal Injuries—The HUNT Study. Sleep 2014, 37, 1777–1786. [Google Scholar] [CrossRef] [Green Version]
- Sivertsen, B.; Overland, S.; Bjorvatn, B.; Maeland, J.G.; Mykletun, A. Does insomnia predict sick leave? The Hordaland Health Study. J. Psychosom. Res. 2009, 66, 67–74. [Google Scholar] [CrossRef] [PubMed]
- Blafoss, R.; Sundstrup, E.; Jakobsen, M.D.; Bay, H.; Garde, A.H.; Andersen, L.L. Are Insomnia Type Sleep Problems Associated With a Less Physically Active Lifestyle? A Cross-Sectional Study Among 7,700 Adults From the General Working Population. Front. Public Health 2019, 7, 117. [Google Scholar] [CrossRef] [PubMed]
- Garbarino, S.; Magnavita, N. Sleep problems are a strong predictor of stress-related metabolic changes in police officers. A prospective study. PLoS ONE 2019, 14, e0224259. [Google Scholar] [CrossRef] [Green Version]
- Phillips, E.A.; Gordeev, V.S.; Schreyögg, J. Effectiveness of occupational e-mental health interventions: A systematic review and meta-analysis of randomized controlled trials. Scand. J. Work Environ. Health 2019, 45, 560–576. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lehr, D.; Heber, E.; Sieland, B.; Hillert, A.; Funk, B.; Ebert, D.D. “Occupational eMental Health” in der Lehrergesundheit: Ein metaanalytisches Review zur Wirksamkeit von Online-Gesundheitstrainings bei Lehrkräften. Pravention und Gesundheitsforderung 2016, 11, 182–192. [Google Scholar] [CrossRef]
- Moher, D.; Shamseer, L.; Clarke, M.; Ghersi, D.; Liberati, A.; Petticrew, M.; Shekelle, P.; Stewart, L.A. PRISMA-P Group Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst. Rev. 2015, 4, 1. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cooper, H. Research Synthesis and Meta-analysis: A Step-by-Step Approach, 5th ed.; Sage Publications: Thousand Oaks, CA, USA, 2017; ISBN 9781483331157. [Google Scholar]
- Higgins, J.P.T.; Altman, D.G.; Gøtzsche, P.C.; Jüni, P.; Moher, D.; Oxman, A.D.; Savović, J.; Schulz, K.F.; Weeks, L.; Sterne, J.A.C. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011, 343. [Google Scholar] [CrossRef] [Green Version]
- Cobos-Carbó, A.; Augustovski, F. Declaración CONSORT 2010: Actualización de la lista de comprobación para informar ensayos clínicos aleatorizados de grupos paralelos. Med. Clin. 2011, 137, 213–215. [Google Scholar] [CrossRef] [Green Version]
- Jaeschke, R.; Guyatt, G.H.; Dellinger, P.; Schunemann, H.; Levy, M.M.; Kunz, R.; Norris, S.; Bion, J. Use of GRADE grid to reach decisions on clinical practice guidelines when consensus is elusive. BMJ 2008, 337, a744. [Google Scholar] [CrossRef]
- Higgins, J.P.T.; Thomas, J. Cochrane Handbook for Systematic Reviews of Interventions; John Wiley & Sons: Noboken, NJ, USA, 2019. [Google Scholar]
- DerSimonian, R.; Laird, N. Meta-analysis in clinical trials. Contemp. Clin. Trials 1986, 7, 177–188. [Google Scholar] [CrossRef]
- Ebert, D.D.; Lehr, D.; Heber, E.; Riper, H.; Cuijpers, P.; Berking, M. Internet- and mobile-based stress management for employees with adherence-focused guidance: Efficacy and mechanism of change. Scand. J. Work Environ. Health 2016, 42, 382–394. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Thiart, H.; Lehr, D.; Ebert, D.D.; Berking, M.; Riper, H. Log in and breathe out: Internet-based recovery training for sleepless employees with work-related strain—Results of a randomized controlled trial. Scand. J. Work Environ. Health 2015. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sadeghniiat-Haghighi, K.; Aminian, O.; Pouryaghoub, G.; Yazdi, Z. Efficacy and hypnotic effects of melatonin in shift-work nurses: Double-blind, placebo-controlled crossover trial. J. Circadian Rhythms 2008, 6. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bostock, S.; Luik, A.I.; Espie, C.A. Sleep and productivity benefits of digital cognitive behavioral therapy for insomnia a randomized controlled trial conducted in the workplace environment. J. Occup. Environ. Med. 2016, 58, 683–689. [Google Scholar] [CrossRef]
- Crain, T.L.; Schonert-Reichl, K.A.; Roeser, R.W. Cultivating teacher mindfulness: Effects of a randomized controlled trial on work, home, and sleep outcomes. J. Occup. Health Psychol. 2017, 22, 138–152. [Google Scholar] [CrossRef] [PubMed]
- Dalgaard, L.; Eskildsen, A.; Carstensen, O.; Willert, M.V.; Andersen, J.H.; Glasscock, D.J. Changes in self-reported sleep and cognitive failures: A randomized controlled trial of a stress management intervention. Scand. J. Work Environ. Health 2014, 40, 569–581. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ebert, D.D.; Berking, M.; Thiart, H.; Riper, H.; Laferton, J.A.C.; Cuijpers, P.; Sieland, B.; Lehr, D. Restoring depleted resources: Efficacy and mechanisms of change of an internet-based unguided recovery training for better sleep and psychological detachment from work. Health Psychol. 2015, 34, 1240–1251. [Google Scholar] [CrossRef] [Green Version]
- Ebert, D.D.; Heber, E.; Berking, M.; Riper, H.; Cuijpers, P.; Funk, B.; Lehr, D. Self-guided internet-based and mobile-based stress management for employees: Results of a randomised controlled trial. Occup. Environ. Med. 2016, 73, 315–323. [Google Scholar] [CrossRef]
- Genin, P.M.; Degoutte, F.; Finaud, J.; Pereira, B.; Thivel, D.; Duclos, M. Effect of a 5-Month Worksite Physical Activity Program on Tertiary Employees Overall Health and Fitness. J. Occup. Environ. Med. 2017, 59, e3–e10. [Google Scholar] [CrossRef]
- Germain, A.; Richardson, R.; Stocker, R.; Mammen, O.; Hall, M.; Bramoweth, A.D.; Begley, A.; Rode, N.; Frank, E.; Haas, G.; et al. Treatment for Insomnia in Combat-Exposed OEF/OIF/OND Military Veterans: Preliminary Randomized Controlled Trial. Behav. Res. Ther. 2014, 61, 78–88. [Google Scholar] [CrossRef] [Green Version]
- Heber, E.; Lehr, D.; Ebert, D.D.; Berking, M.; Riper, H. Web-Based and Mobile Stress Management Intervention for Employees: A Randomized Controlled Trial. J. Med. Internet Res. 2016, 18, e21. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Heli, J.; Mikko, H.; Mikael, S.; Jussi, V.; Teemu, P.; Kari-Pekka, M.; Christer, H. Cognitive behavioural therapy interventions for insomnia among shift workers: RCT in an occupational health setting. Int. Arch. Occup. Environ. Health 2019. [Google Scholar] [CrossRef] [Green Version]
- Kaku, A.; Nishinoue, N.; Takano, T.; Eto, R.; Kato, N.; Ono, Y. Randomized controlled trial on the effects of a combined sleep hygiene education and behavioral approach program on sleep quality in workers with insomnia. Ind. Health 2012, 50, 52–59. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Marino, M.; Berkman, L.F.; Olson, R.; Killerby, M.; Erickson, L.; Buxton, O.M.; Lee, S.; King, R.; Moen, P.; Kossek, E.E.; et al. The effects of a cluster randomized controlled workplace intervention on sleep and work-family conflict outcomes in an extended care setting. Sleep Health 2016, 2, 297–308. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Michailidis, E.; Cropley, M. Testing the benefits of expressive writing for workplace embitterment: A randomized control trial. Eur. J. Work Organ. Psychol. 2019, 28, 315–328. [Google Scholar] [CrossRef]
- Nishinoue, N.; Takano, T.; Kaku, A.; Eto, R.; Kato, N.; Ono, Y.; Tanaka, K. Effects of sleep hygiene education and behavioral therapy on sleep quality of white-collar workers: A randomized controlled trial. Ind. Health 2012, 50, 123–131. [Google Scholar] [CrossRef] [Green Version]
- Olson, R.; Crain, T.L.; Bodner, T.E.; King, R.; Hammer, L.B.; Klein, L.C.; Erickson, L.; Moen, P.; Berkman, L.F.; Buxton, O.M. A workplace intervention improves sleep: Results from the randomized controlled Work, Family, and Health Study. Sleep Health 2015, 1, 55–65. [Google Scholar] [CrossRef]
- Persson Asplund, R.; Dagoo, J.; Fjellstrom, I.; Niemi, L.; Hansson, K.; Zeraati, F.; Ziuzina, M.; Geraedts, A.; Ljotsson, B.; Carlbring, P.; et al. Internet-based stress management for distressed managers: Results from a randomised controlled trial. Occup. Environ. Med. 2018, 75, 105–113. [Google Scholar] [CrossRef]
- Querstret, D.; Cropley, M.; Fife-Schaw, C. Internet-based instructor-led mindfulness for work-related rumination, fatigue, and sleep: Assessing facets of mindfulness as mechanisms of change. A randomized waitlist control trial. J. Occup. Health Psychol. 2017, 22, 153–169. [Google Scholar] [CrossRef] [Green Version]
- Schiller, H.; Söderström, M.; Lekander, M.; Rajaleid, K.; Kecklund, G. A randomized controlled intervention of workplace-based group cognitive behavioral therapy for insomnia. Int. Arch. Occup. Environ. Health 2018. [Google Scholar] [CrossRef] [Green Version]
- Suzuki, E.; Tsuchiya, M.; Hirokawa, K.; Taniguchi, T.; Mitsuhashi, T.; Kawakami, N. Evaluation of an internet-based self-help program for better quality of sleep among Japanese workers: A randomized controlled trial. J. Occup. Health 2008, 50, 387–399. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Yamamoto, M.; Sasaki, N.; Somemura, H.; Nakamura, S.; Kaneita, Y.; Uchiyama, M.; Tanaka, K. Efficacy of sleep education program based on principles of cognitive behavioral therapy to alleviate workers’ distress. Sleep Biol. Rhythms 2016, 14, 211–219. [Google Scholar] [CrossRef]
- Nigatu, Y.T.; Huang, J.; Rao, S.; Gillis, K.; Merali, Z.; Wang, J. Indicated Prevention Interventions in the Workplace for Depressive Symptoms: A Systematic Review and Meta-analysis. Am. J. Prev. Med. 2019, 56, e23–e33. [Google Scholar] [CrossRef] [PubMed]
- Joyce, S.; Shand, F.; Tighe, J.; Laurent, S.J.; Bryant, R.A.; Harvey, S.B. Road to resilience: A systematic review and meta-analysis of resilience training programmes and interventions. BMJ Open 2018, 8, e017858. [Google Scholar] [CrossRef] [Green Version]
- Carolan, S.; Harris, P.R.; Cavanagh, K. Improving Employee Well-Being and Effectiveness: Systematic Review and Meta-Analysis of Web-Based Psychological Interventions Delivered in the Workplace. J. Med. Internet Res. 2017, 19, e271. [Google Scholar] [CrossRef]
- Grist, R.; Croker, A.; Denne, M.; Stallard, P. Technology Delivered Interventions for Depression and Anxiety in Children and Adolescents: A Systematic Review and Meta-analysis. Clin. Child Fam. Psychol. Rev. 2019, 22, 147–171. [Google Scholar] [CrossRef] [Green Version]
- Firth, J.; Torous, J.; Nicholas, J.; Carney, R.; Rosenbaum, S.; Sarris, J. Can smartphone mental health interventions reduce symptoms of anxiety? A meta-analysis of randomized controlled trials. J. Affect. Disord. 2017, 218, 15–22. [Google Scholar] [CrossRef]
- Linardon, J.; Fuller-Tyszkiewicz, M. Attrition and adherence in smartphone-delivered interventions for mental health problems: A systematic and meta-analytic review. J. Consult. Clin. Psychol. 2020, 88, 1–13. [Google Scholar] [CrossRef]
- Zachariae, R.; Lyby, M.S.; Ritterband, L.M.; O’Toole, M.S. Efficacy of internet-delivered cognitive-behavioral therapy for insomnia—A systematic review and meta-analysis of randomized controlled trials. Sleep Med. Rev. 2016, 30, 1–10. [Google Scholar] [CrossRef] [Green Version]
- Ho, F.Y.-Y.; Chung, K.-F.; Yeung, W.-F.; Ng, T.H.; Kwan, K.-S.; Yung, K.-P.; Cheng, S.K. Self-help cognitive-behavioral therapy for insomnia: A meta-analysis of randomized controlled trials. Sleep Med. Rev. 2015, 19, 17–28. [Google Scholar] [CrossRef]
- Vega-Escaño, J.; Porcel-Gálvez, A.M.; Barrientos-Trigo, S.; Romero-Sanchez, J.M.; de Diego-Cordero, R. Turnicity as a determining factor in the occurrence of insomnia in the working population: A systematic review. Rev. Esp. Salud Publica 2020, 94, e202007047. [Google Scholar]
- Boutron, I.; Moher, D.; Altman, D.G.; Schulz, K.F.; Ravaud, P. Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: Explanation and elaboration. Ann. Intern. Med. 2008, 148, 295–309. [Google Scholar] [CrossRef] [PubMed]
- Irwin, M.R.; Cole, J.C.; Nicassio, P.M. Comparative meta-analysis of behavioral interventions for insomnia and their efficacy in middle-aged adults and in older adults 55+ years of age. Health Psychol. 2006, 25, 3–14. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Study | Country | Participants | N | Scale (Insomnia) | Type Intervention | Nº Sessions; Duration Sessions (Min) | Follow-Up | Effect Sizes (IG-CG) | Methodological Quality (CONSORT) |
---|---|---|---|---|---|---|---|---|---|
Bostock et al., 2016 [27] | UK | Office-based staff | 270 | SCI | dCBT | 6/- | 8 weeks/3 months | 1.20 [−0.82, 3.22] | 18/25 |
Crain et al., 2017 [28] | USA | Teachers | 113 | Ad Hoc questionnaire | WMT | 11/120–420 | up to 3 months | −0.40 [−0.99. 0,19] | 18/25 |
Dalgaard et al., 2014 [29] | Denmark | Workers on sick leave | 137 | BNSQ | CBT | 6/60 1–2/60–120 | 4, 10 months | −1.44 [−3.03, −0.15] | 21/25 |
Ebert et al., 2015 [30] | USA | Teachers | 128 | ISI | GET.ON recovery (CBT) | 6/45–60 | 8 weeks/6 months | −5.34 [−6.79, −3.89] | 22/25 |
Ebert, Lehr et al., 2016 [24] | USA | General working population | 264 | ISI | GET-ON stress (iSIM) | 8/45–60 | 7 weeks/ 6 months | −2.83 [−4.14, −1.52] | 23,5/25 |
Ebert, Heber et al., 2016 [31] | USA | General working population | 264 | ISI | GET-ON stress (iSIM) | 8/45–60 | 7 weeks/6 months | −1.90 [−3.32, −0.40] | 21/25 |
Genin et al., 2017 [32] | France | Office employees | 95 | ISI | Worksite physical activity program | 40/45 | 5 months | −1.60 [−3.88, 0.68] a −2.50 [−4.72, −0.28] b | 17/25 |
Germain et al., 2014 [33] | USA | Military | 40 | ISI, PSQI | BBTI-MV | 2 + 2/20–45 | 1, 6 months | −2.18 [−5.20, 0.84] 3.25 [2.22, 4.29] | 19,5/25 |
Heber ar al., 2016 [34] | Germany | General working population | 264 | ISI | GET.ON stress (iSMI) | 7 + 1/30 | 7 weeks/6 months | −2.41 [−3.85, −0.97] | 23/25 |
Järnefelt et al., 2019 [35] | Finland | Shift workers | 83 | ISI | gCBT-I/sCBT-I | (6/90) (6/45) | 6 months | 0.30 [−2.84, 3.44] a 0.10 [−2.76, 2.96] b | 22/25 |
Kaku et al., 2012 [36] | Japan | Design engineers | 223 | PSQI | CBT + SH | 20/30 | 3 months | 1.9 [0.6, 3.4] | 21/25 |
Marino et al., 2016 [37] | USA | Employees and managers (nursing homes) | 1522/184 | PSQI | STAR | 4 + 3/60 | 6, 12 months | 0.00 [−0.10, 0.10] a −0.14 [−0.43, 0.15] b | 20/25 |
Michailidis & Cropley, 2019 [38] | UK | General working population | 44 | ISI | Expressive writing | 3/20 | 1, 3 months | −0.27 [−0.72, 0.18] | 22,5/25 |
Nishinoue et al., 2012 [39] | Japan | White-collar employees | 127 | PSQI | CBT + SH | 1/30 | 3 months | 1.0 [0.02, 2.0] | 18,5/25 |
Olson et al., 2015 [40] | USA | Employees (information technology) | 474 | PSQI | STAR | 3/480 | 6, 12 months | −0.10 [−0.32, 0.12] | 23/25 |
Persson Asplund et al., 2 018 [41] | Sweden | Managers | 117 | ISI | iSIM | 8/120–180 | 6 months | −1.69 [3.47, 0.09] | 23/25 |
Querstret et al., 2017 [42] | UK | General working population | 118 | PSQI | Mindfullness (online) | 10/30 + 10 | 3, 6 months | −0.41 [−0.80, −0.02] | 20,5/25 |
Sadeghniiat-Haghighi et al., 2008 [26] | Iran | Nurses | 86 | Ad Hoc questionnaire | Pharmacological | 3/- | none | −0.11 [−0.29. 0.07] | 18,5/25 |
Schiller et al., 2018 [43] | Sweden | General working population | 51 | ISI | CBT | 5/120 | 3 months | −3.11 [−6.10, −0.12] | 21/25 |
Suzuki et al., 2008 [44] | Japan | General working population | 43 | CSQI/PSQI | CBT | 2 weeks | 3 weeks | −2.09 [−6.70, 2.52] 1.18 [−1.20, 3.56] | 17,5/25 |
Thiart et al., 2015 [25] | Germany | Teachers | 128 | ISI | GET.ON Recovery (CBT) | 6/- | 6 months | −6.44 [−7.98, −4.90] | 23,5/25 |
Yamamoto et al., 2016 [45] | Japan | Office workers | 130 | ISI | CBT-I | 2/30 + 60 | 3 months | −0.29 [−1.37, 0.79] | 21/25 |
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Vega-Escaño, J.; Porcel-Gálvez, A.M.; de Diego-Cordero, R.; Romero-Sánchez, J.M.; Romero-Saldaña, M.; Barrientos-Trigo, S. Insomnia Interventions in the Workplace: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2020, 17, 6401. https://doi.org/10.3390/ijerph17176401
Vega-Escaño J, Porcel-Gálvez AM, de Diego-Cordero R, Romero-Sánchez JM, Romero-Saldaña M, Barrientos-Trigo S. Insomnia Interventions in the Workplace: A Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2020; 17(17):6401. https://doi.org/10.3390/ijerph17176401
Chicago/Turabian StyleVega-Escaño, Juan, Ana María Porcel-Gálvez, Rocío de Diego-Cordero, José Manuel Romero-Sánchez, Manuel Romero-Saldaña, and Sergio Barrientos-Trigo. 2020. "Insomnia Interventions in the Workplace: A Systematic Review and Meta-Analysis" International Journal of Environmental Research and Public Health 17, no. 17: 6401. https://doi.org/10.3390/ijerph17176401