DOI
10.1016/j.smrv.2022.101648
Comparative efficacy and acceptability of cognitive behavioral therapy delivery formats for insomnia in adults: A systematic review and network meta-analysis
作者地址
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
;
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
来源期刊
Sleep Medicine Reviews
摘要
This review compared the efficacy and acceptability of different delivery formats for cognitive behavioral therapy for insomnia (CBT-I) in insomnia. We searched five databases for randomized clinical trials that compared one CBT-I delivery format against another format or control conditions for insomnia in adults. We used pairwise meta-analyses and frequentist network meta-analyses with the random-effects model to synthesize data. A total of 61 unique trials including 11,571 participants compared six CBT-I delivery formats with four control conditions. At post-intervention, with low to high certainty evidence, individual, group, guided self-help, digital assisted, and unguided self-help CBT-I could significantly increase sleep efficiency and total sleep time (TST) and reduce sleep onset latency (SOL), wake after sleep onset (WASO), and insomnia severity compared with treatment as usual (MD range for sleep efficiency: 7.81%-12.45%; MD range for TST: 16.14-33.96 min; MD range for SOL:-22.42 to-13.81 min; MD range for WASO:-40.84 to-19.48 min; MD range for insomnia severity:-6.40 to-3.93) and waitlist (MD range for sleep efficiency: 7.68%-12.32%; MD range for TST: 12.67-30.49 min; MD range for SOL:-19.07 to-10.46 min; MD range for WASO:-47.10 to-19.15 min; MD range for insomnia severity:-7.59 to-5.07). The effects of different CBT-I formats per-sisted at short-term follow-up (4 wk-6 mo). Individual, group, and digital assisted CBT-I delivery formats would be the more appropriate choices for insomnia in adults, based on post-intervention and short-term effects. Further trials are needed to investigate the long-term effects of different CBT-I formats. (c) 2022 Elsevier Ltd. All rights reserved.
资助信息
he National Key Research and Development Program of China (2019YFC1709805);Gansu Province Science and Technology Plan Funded Project (20CX4ZA027, 20CX9ZA112).
资助机构
中华人民共和国科学技术部
;
甘肃省科技厅
WOS学科分类
Neurosciences & Neurology
WOS关键词
CLINICAL-PRACTICE GUIDELINE
;
AMERICAN-COLLEGE
;
SLEEP
;
DISORDER
;
ASSOCIATION
;
MANAGEMENT
;
STATEMENT
;
INCONSISTENCY
;
INTERVENTIONS
;
CONSENSUS
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