| Title | Cognitive behavior therapy for insomnia in cancer patients: a systematic review and network meta-analysis |
| Authors | Gao, Ya Liu, Ming Yao, Liang Yang, Zhirong Chen, Yamin Niu, Mingming Sun, Yue Chen, Ji Hou, Liangying Sun, Feng Wu, Shanshan Zhang, Zeqian Zhang, Junhua Li, Lun Li, Jiang Zhao, Ye Fan, Jingchun Ge, Long Tian, Jinhui |
| Affiliation | Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou 730000, Peoples R China McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada Univ Cambridge, Sch Clin Med, Dept Publ Hlth & Primary Care, Primary Care Unit, Cambridge, England Lanzhou Univ, Sch Nursing, Evidence Based Nursing Ctr, Lanzhou, Peoples R China Peking Univ, Sch Nursing, Beijing, Peoples R China Mianyang Hosp Tradit Chinese Med, Mianyang, Sichuan, Peoples R China Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing, Peoples R China Capital Med Univ, Beijing Friendship Hosp, Natl Clin Res Ctr Digest Dis, Beijing, Peoples R China Univ Hong Kong, Shenzhen Hosp, Shenzhen, Peoples R China Tianjin Univ Tradit Chinese Med, Evidence Based Med Ctr, Tianjin, Peoples R China Cent South Univ, Dept Breast Canc, Xiangya Hosp 2, Changsha, Hunan, Peoples R China Chinese Acad Med Sci & Peking Union Med Coll, Canc Hosp, Natl Clin Res Ctr Canc, Natl Canc Ctr, Beijing, Peoples R China Lanzhou Univ, Clin Med Coll 1, Lanzhou, Peoples R China Indiana Univ Sch Med, Melvin & Bren Simon Comprehens Canc Ctr, Dept Biochem, Indianapolis, IN 46202 USA Indiana Univ Sch Med, Melvin & Bren Simon Comprehens Canc Ctr, Dept Mol Biol, Indianapolis, IN 46202 USA Gansu Univ Chinese Med, Sch Publ Hlth, Epidemiol & Evidence Based Med, Lanzhou, Peoples R China Lanzhou Univ, Evidence Based Social Sci Res Ctr, Sch Publ Hlth, Lanzhou 730000, Peoples R China Key Lab Evidence Based Med & Knowledge Translat G, Lanzhou, Peoples R China |
| Keywords | BREAST-CANCER EFFECTIVENESS TRIAL SLEEP DISRUPTION INCONSISTENCY CONSISTENCY MANAGEMENT WOMEN ARMODAFINIL PREVALENCE DISEASE |
| Issue Date | Aug-2022 |
| Publisher | JOURNAL OF EVIDENCE BASED MEDICINE |
| Abstract | Objective The aim of this study was to examine the most effective delivery format of cognitive behavioral therapy for insomnia (CBT-I) on insomnia in cancer patients. Methods We searched five databases up to February 2021 for randomized clinical trials that compared CBT-I with inactive or active controls for insomnia in cancer patients. Outcomes were insomnia severity, sleep efficiency, sleep onset latency (SOL), wake after sleep onset (WASO), and total sleep time (TST). Pairwise meta-analyses and frequentist network meta-analyses with the random-effects model were applied for data analyses. Results Sixteen unique trials including 1523 participants met inclusion criteria. Compared with inactive control, CBT-I could significantly reduce insomnia severity (mean differences [MD] = -4.98 points, 95% confidence interval [CI]: -5.82 to -4.14), SOL (MD = -12.29 min, 95%CI: -16.48 to -8.09), and WASO (MD = -16.58 min, 95%CI: -22.00 to -11.15), while increasing sleep efficiency (MD = 7.62%, 95%CI: 5.82% to 9.41%) at postintervention. Compared with active control, CBT-I could significantly reduce insomnia severity (MD = -2.75 points, 95%CI: -4.28 to -1.21), SOL (MD = -13.56 min, 95%CI: -18.93 to -8.18), and WASO (MD = -6.99 min, 95%CI: -11.65 to -2.32) at postintervention. These effects diminished in short-term follow-up and almost disappeared in long-term follow-up. Most of the results were rated as "moderate" to "low" certainty of evidence. Network meta-analysis showed that group CBT-I had an increase in sleep efficiency of 10.61%, an increase in TST of 21.98 min, a reduction in SOL of 14.65 min, and a reduction in WASO of 24.30 min, compared with inactive control at postintervention, with effects sustained at short-term follow-up. Conclusions CBT-I is effective for the management of insomnia in cancer patients postintervention, with diminished effects in short-term follow-up. Group CBT-I is the preferred choice based on postintervention and short-term effects. The low quality of evidence and limited sample size demonstrate the need for robust evidence from high-quality, large-scale trials providing long-term follow-up data. |
| URI | http://hdl.handle.net/20.500.11897/650691 |
| ISSN | 1756-5383 |
| DOI | 10.1111/jebm.12485 |
| Indexed | SCI(E) |
| Appears in Collections: | 护理学院 公共卫生学院 |
