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Effects of cognitiv...
Effects of cognitive behavioral therapy for insomnia (CBT-I) on quality of life : A systematic review and meta-analysis
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- Alimoradi, Zainab (author)
- Qazvin Univ Med Sci, Iran,Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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- Jafari, Elahe (author)
- Qazvin Univ Med Sci, Iran,Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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- Broström, Anders (author)
- Jönköping University,HHJ, Avdelningen för omvårdnad,HHJ. ADULT,Region Östergötland, Neurofysiologiska kliniken US,Jonkoping Univ, Sweden
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- Ohayon, Maurice M. (author)
- Stanford Univ, CA 94305 USA,Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, CA, United States
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- Lin, Chung-Ying (author)
- Natl Cheng Kung Univ, Taiwan;Natl Cheng Kung Univ Hosp, Taiwan,Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan,Natl Cheng Kung Univ, Taiwan; Natl Cheng Kung Univ, Taiwan; Natl Cheng Kung Univ, Taiwan; Natl Cheng Kung Univ, Taiwan
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- Griffiths, Mark D. (author)
- Nottingham Trent Univ, UK,International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom,Nottingham Trent Univ, England
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- Blom, Kerstin (author)
- Karolinska Institutet
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- Jernelov, Susanna (author)
- Karolinska Institutet
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- Kaldo, Viktor, Professor (author)
- Linnéuniversitetet,Institutionen för psykologi (PSY),Karolinska Institutet, Sweden;Region Stockholm, Sweden,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm,Karolinska Inst, Sweden; Huddinge Hosp, Sweden; Linnaeus Univ, Sweden
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- Pakpour, Amir H. (author)
- Jönköping University,HHJ, Avdelningen för omvårdnad,Jonkoping Univ, Sweden
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(creator_code:org_t)
- Elsevier, 2022
- 2022
- English.
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In: Sleep Medicine Reviews. - : Elsevier. - 1087-0792 .- 1532-2955. ; 64
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Abstract
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- The effects of cognitive behavioral therapy for insomnia (CBT-I) have consistently been shown to improve insomnia symptoms and other health-related outcomes, but the effects on QoL have been inconsistent. Many factors including the type CBT-I delivery and type of instrument used to assess QoL make the topic complex. The present systematic review and meta-analysis synthesized the evidence of CBT-I efficacy on QoL outcomes across different populations, delivery modes, and methodological aspects. Following the guidelines on preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a literature search was conducted through PubMed, Web of Science, Scopus, and PsycINFO using keywords from relevant MeSH terms based on PICOS (Participants, Intervention, Comparison, Outcome and Study) criteria. Clinical trials investigating the effect of CBT-I as an intervention on QoL with any kind of control group were eligible if they reported mean scores and variation of QoL. Meta-analysis using a random-effect model was conducted to calculate the standardized mean differences (SMDs) in a set including all identified studies, as well as in three sub-sets: face-to-face CBT-I using randomized controlled trials (RCTs), online CBT-I using RCTs, and one-group pre- and post-treatment design. A total of 24 studies comprising 1977 participants (808 in an intervention group) from 12 countries were eligible for meta-analysis. The overall pooled estimate of SMD of QoL when all 24 studies were included was 0.47 (95% CI: 0.22; 0.72; I-2 = 84.5%; tau(2) = 0.31; p < 0.001). The overall pooled estimate of SMD of QoL was 0.46 (95% CI: 0.01-0.90; I-2 = 87.5%; tau(2) = 0.48, p < 0.001) for intervention groups with face-to-face CBT-I compared to controls; 0.47 (95% CI: 0.02-0.92; I-2 = 88.3%; tau(2) = 0.36; p = 0.04) for intervention groups with digital CBT-I compared to controls, and 0.46 (95% CI: 0.12-0.80; I-2 = 52.9%; tau(2) = 0.07; p = 0.08) for one-group pre- and post-comparison using CBT-I intervention compared to baseline. Moreover, effects of CBT-I on QoL were different across populations (pooled SMD = 0.59 for patients with insomnia; 0.29 for patients with insomnia comorbid with another major disorder; and 0.48 for other conditions) and types of QoL instruments (pooled SMD = 0.36 for disease-specific QoL instrument not on insomnia, 0.43 for generic QoL instrument, and 0.67 for a single-QoL-item instrument). The probability of publication bias was ruled out in overall and design specific sub-group analysis based on funnel plot and Egger's test. In conclusion, this meta-analysis confirmed a moderate, overall effect of CBT-I in improving QoL. However, due to small power and heterogeneity, future studies are needed to better explore the impact of moderating factors such as mode of delivery and type of QoL measure for assessment used. (C) 2022 The Author(s). Published by Elsevier Ltd.
Subject headings
- SAMHÄLLSVETENSKAP -- Psykologi (hsv//swe)
- SOCIAL SCIENCES -- Psychology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- Cognitive behavioral therapy
- Insomnia
- CBT-I
- Quality of life
- Systematic review
- Meta-analysis
- Psychology
- Psykologi
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Alimoradi, Zaina ...
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Jafari, Elahe
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Broström, Anders
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Ohayon, Maurice ...
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Lin, Chung-Ying
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Griffiths, Mark ...
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Blom, Kerstin
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Jernelov, Susann ...
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Kaldo, Viktor, P ...
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Pakpour, Amir H.
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- About the subject
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- SOCIAL SCIENCES
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SOCIAL SCIENCES
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and Psychology
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MEDICAL AND HEAL ...
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and Health Sciences
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and Public Health Gl ...
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MEDICAL AND HEAL ...
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Sleep Medicine R ...
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Linnaeus University
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Jönköping University
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Linköping University
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Karolinska Institutet