The impact of cognitive-behavior therapy for anxiety disorders on concomitant sleep disturbances: A meta-analysis

Introduction: Sleep disturbances are present in approximately 70% of individuals with an anxiety disorder (AD). Treatments for AD may alleviate associated sleep problems, but empirical support for this view is sparse. Objective: To assess state of knowledge about the impact of CBT for AD on sleep disturbances. Method: Systematic search for clinical trials of CBT for any AD in PsycINFO, MedLine, and Proquest Dissertations and Theses. Results: Of 1205 studies, only 25 (2.07%) reported sleep data. The combined ES of CBT for AD on sleep was 0.527 [95%CI 0.306-0.748], indicating a moderate effect of anxiety treatment on concomitant sleep difficulties. The impact did not significantly differ according to study design, sleep variable or anxiety disorder. Conclusions: Although substantial amounts of research documented the efficacy of CBT for AD, very few reported its effect on concomitant sleep problems. Current state of knowledge does not permit definitive conclusions and future research is needed.