The impact of cognitive behavioural therapy for insomnia on objective sleep parameters: A meta-analysis and systematic review

Sleep Medicine Reviews
Laura J MitchellSimon D Kyle

Abstract

It is well-established that cognitive behavioural therapy for insomnia (CBT-I) improves self-reported sleep disturbance, however the impact on objective sleep is less clear. This meta-analysis aimed to quantify the impact of multi-component CBT-I on objective measures of sleep, indexed via polysomnography (PSG) and actigraphy. Fifteen studies met inclusion criteria. Following appraisal for risk of bias, extracted data were meta-analysed using random-effects models. The quality of the literature was generally high, although reporting of methodological detail varied markedly between studies. Meta-analyses found no evidence that CBT-I reliably improves PSG-defined sleep parameters. Actigraphy evidence was more mixed; with a small effect for reduction in sleep onset latency (Hedge's g = -0.28 [95% confidence interval (CI) -0.51 to -0.05], p = 0.018) and a moderate effect for reduction in total sleep time (TST) (Hedge's g = -0.51 [95% CI -0.75 to -0.26], p < 0.001). In contrast, and consistent with recent meta-analyses, CBT-I was associated with robust improvements in diary measures of sleep initiation and maintenance (Hedge's g range = 0.50 to 0.79) but not TST. While the literature is small and still developing, the sleep benefits...Continue Reading

Citations

Oct 9, 2020·European Journal of Psychotraumatology·Catrin LewisJonathan I Bisson
May 29, 2020·Sleep Health·Allison L SoprovichSteven T Johnson
Feb 3, 2021·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Sarika MadariBhanu Prakash Kolla
Feb 19, 2021·European Journal of Sport Science·Andrea BallesioChiara Baglioni
Feb 9, 2021·International Journal of Clinical Practice·Laura Hrehová, Kamal Mezian
Mar 6, 2021·Sleep Medicine Reviews·Gavin BrupbacherArno Schmidt-Trucksäss
Apr 7, 2021·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Ngan Yin ChanYun Kwok Wing
Jul 20, 2021·Journal of American College Health : J of ACH·Kimberly R HartsonSara A Choate
Jul 24, 2021·Disability and Rehabilitation·Carolina Climent-SanzMontserrat Gea-Sánchez
Aug 10, 2021·Frontiers in Neuroscience·Zahra VaziriIman Ghodratitoostani
Oct 6, 2021·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Lauren E CudneySheryl M Green

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