Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis
Abstract Given the limited availability and accessibility of onsite cognitive behavioral therapy for insomnia (CBT-I), other CBT-I settings, such as internet-delivered CBT-I (iCBT-I), have been proposed. The primary aim of the study was to compare the efficacy of available CBT-I settings on insomnia...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-02-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-28853-0 |
| _version_ | 1811171728878993408 |
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| author | Laura Simon Lisa Steinmetz Bernd Feige Fee Benz Kai Spiegelhalder Harald Baumeister |
| author_facet | Laura Simon Lisa Steinmetz Bernd Feige Fee Benz Kai Spiegelhalder Harald Baumeister |
| author_sort | Laura Simon |
| collection | DOAJ |
| description | Abstract Given the limited availability and accessibility of onsite cognitive behavioral therapy for insomnia (CBT-I), other CBT-I settings, such as internet-delivered CBT-I (iCBT-I), have been proposed. The primary aim of the study was to compare the efficacy of available CBT-I settings on insomnia severity. A systematic review and frequentist network meta-analysis of available CBT-I settings was performed. PsycINFO, PsycARTICLES, MEDLINE, PubMed, and CINAHL were searched for randomized controlled trials (RCTs) investigating any CBT-I settings in adults with insomnia disorder. The systematic literature search (3851 references) resulted in 52 RCTs. For the primary outcome insomnia severity, all examined CBT-I settings except smartphone-delivered CBT-I yielded significant effects when compared to WL. Large standardized mean differences were found for individual onsite CBT-I (− 1.27;95%CI − 1.70, − 0.84), group-delivered CBT-I (− 1.00;95%CI − 1.42. − 0.59), telehealth (− 1.28;95%CI − 2.06, − 0.50), and guided bibliotherapy (− 0.99;95%CI − 1.67, − 0.32). Both guided iCBT-I (− 0.71;95%CI − 1.18, − 0.24) and unguided iCBT-I (− 0.78;95%CI − 1.18, − 0.38) yielded medium effect sizes. The results underline that health care systems should intensify their efforts to provide synchronously-delivered CBT-I (individual onsite, group-delivered, and telehealth), and particularly individual onsite CBT-I, given its solid evidence base. Medium to large effect sizes for iCBT-I and guided bibliotherapy indicate that self-help settings may be a viable alternative when synchronously-delivered CBT-I is not available. |
| first_indexed | 2024-04-10T17:19:57Z |
| format | Article |
| id | doaj.art-e63bd5366ee14130bbce261ad70d3242 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-10T17:19:57Z |
| publishDate | 2023-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-e63bd5366ee14130bbce261ad70d32422023-02-05T12:13:13ZengNature PortfolioScientific Reports2045-23222023-02-0113111110.1038/s41598-023-28853-0Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysisLaura Simon0Lisa Steinmetz1Bernd Feige2Fee Benz3Kai Spiegelhalder4Harald Baumeister5Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University UlmDepartment of Psychiatry and Psychotherapy, Medical Center–University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Psychiatry and Psychotherapy, Medical Center–University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Psychiatry and Psychotherapy, Medical Center–University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Psychiatry and Psychotherapy, Medical Center–University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University UlmAbstract Given the limited availability and accessibility of onsite cognitive behavioral therapy for insomnia (CBT-I), other CBT-I settings, such as internet-delivered CBT-I (iCBT-I), have been proposed. The primary aim of the study was to compare the efficacy of available CBT-I settings on insomnia severity. A systematic review and frequentist network meta-analysis of available CBT-I settings was performed. PsycINFO, PsycARTICLES, MEDLINE, PubMed, and CINAHL were searched for randomized controlled trials (RCTs) investigating any CBT-I settings in adults with insomnia disorder. The systematic literature search (3851 references) resulted in 52 RCTs. For the primary outcome insomnia severity, all examined CBT-I settings except smartphone-delivered CBT-I yielded significant effects when compared to WL. Large standardized mean differences were found for individual onsite CBT-I (− 1.27;95%CI − 1.70, − 0.84), group-delivered CBT-I (− 1.00;95%CI − 1.42. − 0.59), telehealth (− 1.28;95%CI − 2.06, − 0.50), and guided bibliotherapy (− 0.99;95%CI − 1.67, − 0.32). Both guided iCBT-I (− 0.71;95%CI − 1.18, − 0.24) and unguided iCBT-I (− 0.78;95%CI − 1.18, − 0.38) yielded medium effect sizes. The results underline that health care systems should intensify their efforts to provide synchronously-delivered CBT-I (individual onsite, group-delivered, and telehealth), and particularly individual onsite CBT-I, given its solid evidence base. Medium to large effect sizes for iCBT-I and guided bibliotherapy indicate that self-help settings may be a viable alternative when synchronously-delivered CBT-I is not available.https://doi.org/10.1038/s41598-023-28853-0 |
| spellingShingle | Laura Simon Lisa Steinmetz Bernd Feige Fee Benz Kai Spiegelhalder Harald Baumeister Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis Scientific Reports |
| title | Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis |
| title_full | Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis |
| title_fullStr | Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis |
| title_full_unstemmed | Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis |
| title_short | Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis |
| title_sort | comparative efficacy of onsite digital and other settings for cognitive behavioral therapy for insomnia a systematic review and network meta analysis |
| url | https://doi.org/10.1038/s41598-023-28853-0 |
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