Comparative efficacy and acceptability of psychotherapies, pharmacotherapies, and their combination for the treatment of adult insomnia: A systematic review and network meta-analysis

被引：18

作者：

Zhang, Ye ^{[1
,2
]}

Ren, Rong ^{[1
,2
,6
,7
]}

Yang, Linghui ^{[1
,2
]}

Zhang, Haipeng ^{[1
,2
]}

Shi, Yuan ^{[1
,2
]}

Shi, Jie ^{[3
]}

Sanford, Larry D. ^{[4
]}

Lu, Lin ^{[3
]}

Vitiello, Michael V. ^{[5
]}

Tang, Xiangdong ^{[1
,2
,6
,7
]}

机构：

[1] Sichuan Univ, West China Hosp, Sleep Med Ctr, Dept Resp & Crit Care Med,Mental Hlth Ctr,Translat, Chengdu, Peoples R China

[2] Sichuan Univ, West China Hosp, State Key Lab Biotherapy, Chengdu, Peoples R China

[3] Peking Univ, Peking Univ Hosp 6, Natl Inst Drug Dependence, Beijing 100191, Peoples R China

[4] Eastern Virginia Med Sch, Ctr Integrat Neurosci & Inflammatory Dis, Dept Pathol & Anat, Sleep Res Lab, Norfolk, VA USA

[5] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA

[6] Sichuan Univ, West China Hosp, Sleep Med Ctr, Dept Resp & Crit Care Med,Mental Hlth Ctr,Translat, Dian Xin Nan Jie 28, Chengdu 610041, Peoples R China

[7] Sichuan Univ, West China Hosp, State Key Lab Biotherapy, Dian Xin Nan Jie 28, Chengdu 610041, Peoples R China

来源：

SLEEP MEDICINE REVIEWS | 2022年 / 65卷

基金：

中国国家自然科学基金;

关键词：

Cognitive behavior therapy; Cognitive therapy; Behavior therapy; Psychotherapy; Pharmacotherapy; Insomnia; COGNITIVE-BEHAVIORAL THERAPY; CLINICAL-PRACTICE GUIDELINE; RANDOMIZED CONTROLLED-TRIAL; PSYCHOLOGICAL TREATMENT; AMERICAN ACADEMY; MANAGEMENT; INCONSISTENCY; CONSISTENCY; DISORDER; MODELS;

D O I：

10.1016/j.smrv.2022.101687

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

This study aims to explore the comparative efficacy and acceptability of psychotherapies, pharmaco-therapies, and their combinations for insomnia. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, and ClinicalTrials.gov were searched for randomized clinical trials (RCTs) examining the comparative efficacy in which a psychotherapy and a pharmacotherapy for insomnia were directly compared with each other, or in which a combination of psychotherapy and pharmacotherapy was compared with either alone. The analysis included data from 23 RCTs. In 18 of 23 studies, cognitive behavior therapy for insomnia (CBT-I) was the psychotherapy. At post-treatment, CBT-I showed higher subjective sleep efficiency (SE), and lower subjective wake time after sleep onset (WASO) and insomnia severity index (ISI) score. Compared with CBT-I plus pharmacotherapy, pharmacotherapy showed lower subjective SE, and higher subjective sleep latency (SL), PSG measured SL, subjective WASO, and ISI score. Overall, the findings derived from post-treatment data suggested that CBT-I is more beneficial in treating insomnia compared with pharmacotherapy. CBT-I combined with pharmacotherapy is beneficial in improving some sleep parameters (i.e., subjective SE, SL, WASO, and PSG measured SL) compared with pharmacotherapy alone. Daily clinical decisions should consider these findings on the relative efficacy of the principal approaches to insomnia treatment. (c) 2022 Elsevier Ltd. All rights reserved.

引用

页数：9