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
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 inso...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/11/15/2207 |
| _version_ | 1797586759332134912 |
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| author | Danny J. Yu Francesco Recchia Joshua D. K. Bernal Angus P. Yu Daniel Y. Fong Shirley X. Li Rachel N. Y. Chan Xiaoqing Hu Parco M. Siu |
| author_facet | Danny J. Yu Francesco Recchia Joshua D. K. Bernal Angus P. Yu Daniel Y. Fong Shirley X. Li Rachel N. Y. Chan Xiaoqing Hu Parco M. Siu |
| author_sort | Danny J. Yu |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T00:26:45Z |
| format | Article |
| id | doaj.art-b87f28cdada146a59e69043a2f641549 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-11T00:26:45Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-b87f28cdada146a59e69043a2f6415492023-11-18T22:57:01ZengMDPI AGHealthcare2227-90322023-08-011115220710.3390/healthcare11152207Effectiveness 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 TrialsDanny J. Yu0Francesco Recchia1Joshua D. K. Bernal2Angus P. Yu3Daniel Y. Fong4Shirley X. Li5Rachel N. Y. Chan6Xiaoqing Hu7Parco M. Siu8Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, ChinaDivision of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, ChinaDivision of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, ChinaDivision of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, ChinaSchool of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, ChinaDepartment of Psychology, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, ChinaLi Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, ChinaDepartment of Psychology, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, ChinaDivision of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, ChinaDespite 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.https://www.mdpi.com/2227-9032/11/15/2207chronic insomniaexercisecognitive-behavioral therapy for insomnia (CBT-I)pharmacotherapynetwork meta-analysis |
| spellingShingle | Danny J. Yu Francesco Recchia Joshua D. K. Bernal Angus P. Yu Daniel Y. Fong Shirley X. Li Rachel N. Y. Chan Xiaoqing Hu Parco M. Siu 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 Healthcare chronic insomnia exercise cognitive-behavioral therapy for insomnia (CBT-I) pharmacotherapy network meta-analysis |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | chronic insomnia exercise cognitive-behavioral therapy for insomnia (CBT-I) pharmacotherapy network meta-analysis |
| url | https://www.mdpi.com/2227-9032/11/15/2207 |
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