Insomnia, the most prevalent sleep disorder worldwide, confers marked risks for both physical and mental health. Furthermore, insomnia is associated with considerable direct and indirect healthcare costs. Recent guidelines in the US and Europe unequivocally conclude that cognitive behavioural therapy for insomnia (CBT‐I) should be the first‐line treatment for the disorder. Current treatment approaches are in stark contrast to these clear recommendations, not least across Europe, where, if any treatment at all is delivered, hypnotic medication still is the dominant therapeutic modality. To address this situation, a Task Force of the European Sleep Research Society and the European Insomnia Network met in May 2018. The Task Force proposed establishing a European CBT‐I Academy that would enable a Europe‐wide system of standardized CBT‐I training and training centre accreditation. This article summarizes the deliberations of the Task Force concerning definition and ingredients of CBT‐I, preconditions for health professionals to teach CBT‐I, the way in which CBT‐I should be taught, who should be taught CBT‐I and to whom CBT‐I should be administered. Furthermore, diverse aspects of CBT‐I care and delivery were discussed and incorporated into a stepped‐care model for insomnia.

BackgroundObesity and stress are among the most common lifestyle-related health problems. Most of the current disease prevention and management models are not satisfactorily cost-effective and hardly reach those who need them the most. Therefore, novel evidence-based controlled interventions are necessary to evaluate models for prevention and treatment based on self-management. This randomized controlled trial examines the effectiveness, applicability, and acceptability of different lifestyle interventions with individuals having symptoms of metabolic syndrome and psychological distress. The offered interventions are based on cognitive behavioral approaches, and are designed for enhancing general well-being and supporting personalized lifestyle changes.Methods/Design339 obese individuals reporting stress symptoms were recruited and randomized to either (1) a minimal contact web-guided Cognitive Behavioral Therapy-based (CBT) intervention including an approach of health assessment and coaching methods, (2) a mobile-guided intervention comprising of mindfulness, acceptance and value-based exercises, (3) a face-to-face group intervention using mindfulness, acceptance and value-based approach, or (4) a control group. The participants were measured three times during the study (pre = week 0, post = week 10, and follow-up = week 36). Psychological well-being, lifestyles and habits, eating behaviors, and user experiences were measured using online surveys. Laboratory measurements for physical well-being and general health were performed including e.g. liver function, thyroid glands, kidney function, blood lipids and glucose levels and body composition analysis. In addition, a 3-day ambulatory heart rate and 7-day movement data were collected for analyzing stress, recovery, physical activity, and sleep patterns. Food intake data were collected with a 48 -hour diet recall interview via telephone. Differences in the effects of the interventions would be examined using multiple-group modeling techniques, and effect-size calculations.DiscussionThis study will provide additional knowledge about the effects of three low intensity interventions for improving general well-being among individuals with obesity and stress symptoms. The study will show effects of two technology guided self-help interventions as well as effect of an acceptance and value–based brief group intervention. Those who might benefit from the aforesaid interventions will increase knowledge base to better understand what mechanisms facilitate effects of the interventions.Trial registrationCurrent Clinical Trials NCT01738256, Registered 17 August, 2012.

Background: Cognitively straining conditions such as disruptions, interruptions, and information overload are related to impaired task performance and diminished well-being at work. It is therefore essential that we reduce their harmful consequences to individual employees and organizations. Our intervention study implements practices for managing the cognitive strain typical to office work tasks and working conditions in offices. We will examine the effects of a cognitive ergonomics intervention on working conditions, workflow, well-being, and productivity. Methods/design: The study is a stratified cluster randomized trial. The clusters are work units, for example, teams or offices. The four participating organizations entered a total of 36 clusters, and we invited all 1169 knowledge employees of these units to participate. We randomly allocated the clusters into an intervention group (cognitive ergonomics) or an active control group (recovery supporting). We invited an additional 471 participants to join a passive control group only for baseline and follow-up measurements, with no intervention. The study consists of a baseline survey and interviews and observations at the workplace, followed by an intervention. It starts with a workshop defining the specific actions for the intervention implementation stage, during which we send task reminder questionnaires to all employees to support behaviour change at the individual and team levels. The primary outcome measure is perceived frequency of cognitive strain from working conditions; the secondary outcome measures include subjective cognitive load, well-being, workflow/productivity, and cognitive stress symptoms. Process evaluation uses the quantitative and qualitative data obtained during the implementation and evaluation phases. The baseline measurements, intervention phase, and end-of-treatment measurements are now complete, and follow-up will continue until November 2019. Discussion: There is a need to expand the research of cognitive strain, which poses a considerable risk to work performance and employee well-being in cognitively demanding tasks. Our study will provide new information about factors that contribute to such strain. Most importantly, the results will show which evidence-based cognitive ergonomic practices support work performance in knowledge work, and the project will provide concrete examples of how to improve at work.

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