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Article: Effectiveness of Exercise, Cognitive Behavioral Therapy, and Pharmacotherapy on Improving Sleep in Adults with Chronic Insomnia: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

TitleEffectiveness of Exercise, Cognitive Behavioral Therapy, and Pharmacotherapy on Improving Sleep in Adults with Chronic Insomnia: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials
Authors
Keywordschronic insomnia
cognitive-behavioral therapy for insomnia (CBT-I)
exercise
network meta-analysis
pharmacotherapy
Issue Date4-Aug-2023
PublisherMDPI
Citation
Healthcare, 2023, v. 11, n. 15 How to Cite?
Abstract

Despite the well-established treatment effectiveness of exercise, cognitive behavioral therapy for insomnia (CBT-I), and pharmacotherapy on improving sleep, there have been no studies to compare their long-term effectiveness, which is of clinical importance for sustainable management of chronic insomnia. This study compared the long-term effectiveness of these three interventions on improving sleep in adults with chronic insomnia. MEDLINE, PsycINFO, Embase, and SPORTDiscus were searched for eligible reports. Trials that investigated the long-term effectiveness of these three interventions on improving sleep were included. The post-intervention follow-up of the trial had to be ≥6 months to be eligible. The primary outcome was the long-term effectiveness of the three interventions on improving sleep. Treatment effectiveness was the secondary outcome. A random-effects network meta-analysis was carried out using a frequentist approach. Thirteen trials were included in the study. After an average post-intervention follow-up period of 10.3 months, both exercise (SMD, -0.29; 95% CI, -0.57 to -0.01) and CBT-I (-0.48; -0.68 to -0.28) showed superior long-term effectiveness on improving sleep compared with control. Temazepam was the only included pharmacotherapy, which demonstrated superior treatment effectiveness (-0.80; -1.25 to -0.36) but not long-term effectiveness (0.19; -0.32 to 0.69) compared with control. The findings support the use of both exercise and CBT-I for long-term management of chronic insomnia, while temazepam may be used for short-term treatment.


Persistent Identifierhttp://hdl.handle.net/10722/331788
ISSN
2023 Impact Factor: 2.4
2023 SCImago Journal Rankings: 0.606
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYu, DJ-
dc.contributor.authorRecchia, F-
dc.contributor.authorBernal, JDK-
dc.contributor.authorYu, AP-
dc.contributor.authorFong, DY-
dc.contributor.authorLi, SX-
dc.contributor.authorChan, RNY-
dc.contributor.authorHu, XQ-
dc.contributor.authorSiu, PM-
dc.date.accessioned2023-09-21T06:58:55Z-
dc.date.available2023-09-21T06:58:55Z-
dc.date.issued2023-08-04-
dc.identifier.citationHealthcare, 2023, v. 11, n. 15-
dc.identifier.issn2227-9032-
dc.identifier.urihttp://hdl.handle.net/10722/331788-
dc.description.abstract<p>Despite the well-established treatment effectiveness of exercise, cognitive behavioral therapy for insomnia (CBT-I), and pharmacotherapy on improving sleep, there have been no studies to compare their long-term effectiveness, which is of clinical importance for sustainable management of chronic insomnia. This study compared the long-term effectiveness of these three interventions on improving sleep in adults with chronic insomnia. MEDLINE, PsycINFO, Embase, and SPORTDiscus were searched for eligible reports. Trials that investigated the long-term effectiveness of these three interventions on improving sleep were included. The post-intervention follow-up of the trial had to be ≥6 months to be eligible. The primary outcome was the long-term effectiveness of the three interventions on improving sleep. Treatment effectiveness was the secondary outcome. A random-effects network meta-analysis was carried out using a frequentist approach. Thirteen trials were included in the study. After an average post-intervention follow-up period of 10.3 months, both exercise (SMD, -0.29; 95% CI, -0.57 to -0.01) and CBT-I (-0.48; -0.68 to -0.28) showed superior long-term effectiveness on improving sleep compared with control. Temazepam was the only included pharmacotherapy, which demonstrated superior treatment effectiveness (-0.80; -1.25 to -0.36) but not long-term effectiveness (0.19; -0.32 to 0.69) compared with control. The findings support the use of both exercise and CBT-I for long-term management of chronic insomnia, while temazepam may be used for short-term treatment.<br></p>-
dc.languageeng-
dc.publisherMDPI-
dc.relation.ispartofHealthcare-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectchronic insomnia-
dc.subjectcognitive-behavioral therapy for insomnia (CBT-I)-
dc.subjectexercise-
dc.subjectnetwork meta-analysis-
dc.subjectpharmacotherapy-
dc.titleEffectiveness of Exercise, Cognitive Behavioral Therapy, and Pharmacotherapy on Improving Sleep in Adults with Chronic Insomnia: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials-
dc.typeArticle-
dc.identifier.doi10.3390/healthcare11152207-
dc.identifier.scopuseid_2-s2.0-85168288981-
dc.identifier.volume11-
dc.identifier.issue15-
dc.identifier.eissn2227-9032-
dc.identifier.isiWOS:001045440600001-
dc.identifier.issnl2227-9032-

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