The DOI matches its Crossref record; 62 of the 62 references it cites were found in a registry or an index.
The efficacy of cognitive and behavior therapies for insomnia on daytime symptoms: A systematic review and network meta-analysis
Open accessAbstract
Insomnia disorder, defined by nocturnal and daytime symptoms, is highly prevalent worldwide and is associated with the onset of mental illness. Although daytime symptoms are often the reason insomnia patients seek help, it is not clear whether recommended treatment is effective on daytime symptoms. We aimed to investigate the efficacy of cognitive and behavior therapies for insomnia (CBT-I) on all daytime symptoms explored in the literature using both direct and indirect data. 86 studies (15,578 participants) met inclusion criteria. Results showed significant effects of CBT-I administered face-to-face individually, in group and different self-help settings on depressive symptoms, anxiety, daytime sleepiness, fatigue, quality of life, daytime and social functioning and mental state, with Cohen's d's ranging from -0.52 and 0.81. Our results suggest that CBT-I is effective in the treatment of daytime symptoms, albeit with predominantly small to moderate effects compared to far stronger effects on the core symptoms of insomnia. Effects may be biased for depressive and anxiety symptoms, since many included studies excluded patients with severe levels of these complaints. Further, small to moderate effects may reflect that CBT-I, by improving nighttime symptoms, has a positive effect on daytime symptoms, but it does not target the daytime symptoms directly. Future studies may benefit from adding therapeutic techniques that address daytime symptoms more directly.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“yet little research has investigated the effect of other sleep interventions on anxiety symptoms.”
From Do non-pharmacological sleep interventions affect anxiety symptoms? A meta-analysis (2022) · cites this paper as Benz et al., 2020
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Additionally, this meta-analysis comments that effects may be biased given many studies excluded participants with severe levels of anxiety.”
From Do non-pharmacological sleep interventions affect anxiety symptoms? A meta-analysis (2022) · cites this paper as Benz et al., 2020
Experimental — accuracy not yet measuredIn the citing paper
“In patients with insomnia without psychiatric comorbidity, CBT-I is highly effective for the improvement of self-rated insomnia severity and several other sleep parameters like for example sleep onset latency and wake time after sleep onset [9], including daytime symptoms [10].”
From Cognitive behavioral therapy for insomnia in patients with mental disorders and comorbid insomnia: A systematic review and meta-analysis (2022) · cites this paper as [10]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
R: A Language and Environment for Statistical Computing
R Core Team (2000) · doi:10.32614/r.manuals · Cited by 355,893
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763
The Cochrane Collaboration's tool for assessing risk of bias in randomised trials
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., et al. (2011) · BMJ · doi:10.1136/bmj.d5928 · Cited by 33,817
Hutton, B., Salanti, G., Caldwell, D. M., Chaimani, A., Schmid, C. H., Cameron, C., Ioannidis, J. P. A., Straus, S., Thorlund, K., Jansen, J. P., et al. (2015) · Annals of Internal Medicine · doi:10.7326/m14-2385 · Cited by 8,269 · cited 1×
“Analyses (PRISMA-NMA) guidelines (Hutton et al., 2015) which is an extension of the original PRISMA guidelines (Moher, Liberati, Tetzlaff, Altman, & The PRISMA Group, 2009) specialized for reporting systematic reviews incorporating network meta-analyses.”
MethodEpidemiology of insomnia: what we know and what we still need to learn
Ohayon, M. M. (2002) · Sleep Medicine Reviews · doi:10.1053/smrv.2002.0186 · Cited by 3,743
Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., Lombardo, C., & Riemann, D. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.01.011 · Cited by 2,779 · cited 1×
“, 2014) as well as psychiatric disorders, especially depression and anxiety disorders (Baglioni et al., 2011; Hertenstein et al., 2019).”
BackgroundGraphical tools for network meta-analysis in STATA
Chaimani, A., Higgins, J. P. T., Mavridis, D., Spyridonos, P., & Salanti, G. (2013) · PLoS ONE · doi:10.1371/journal.pone.0076654 · Cited by 2,473
Flagged first, then by citations
Cited by
Sorted by citations
Items 101–142 of 142
Arentson‐Lantz, E. J., Muench, A., Kokonda, M., Meers, J. M., Swartz, M. C.-Y. C., Manber, R., Thurston, R. C., & Nowakowski, S. (2026) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0000000000002779 · Cited by 2
“A comprehensive systematic review and network meta-analysis 65 found that although CBT-I produces moderate improvements in sleep, its effects on daytime outcomes (eg, fatigue, mood, role/occupational functioning) are generally small-to-moderate, indicating that daytime recovery may require…”
Artificial Intelligence in Couple and Family Therapy: Systemic Ethical Principles
Hertlein, K. M., Springer, P. R., & Rajaei, A. (2026) · International Journal of Systemic Therapy · doi:10.1080/2692398x.2026.2691467 · Cited by 1
Hardman, J. R., Rees, C. S., Bonnar, D., & Ree, M. J. (2023) · Clinical Psychologist · doi:10.1080/13284207.2022.2155034 · Cited by 1
Corkum, P. V., Bertrand, M., Ilie, A., & Rajda, M. (2023) · Autism and child psychopathology series · doi:10.1007/978-3-031-41709-2_10 · Cited by 1
da Silva, K. M., Griffiths, C., Banazadeh, A., & Mu, M. (2025) · Open Journal of Psychiatry · doi:10.4236/ojpsych.2025.152010 · Cited by 1
Future directions in insomnia diagnosis and treatment
Baglioni, C., Spiegelhalder, K., Nissen, C., & Riemann, D. W. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-822963-7.00026-8 · Cited by 1
Cognitive behavioral therapy for insomnia: a transdiagnostic intervention?
Hall, D. L., Hall, K. A. A., Liverant, G. I., Park, E. R., Gorman, M. J., & Balkind, E. G. (2025) · SLEEP · doi:10.1093/sleep/zsaf079 · Cited by 1
Miller‐Mendes, M., Castilho, P., Clara, M. I., Clemente, V., & Gomes, A. A. (2026) · British Journal of Clinical Psychology · doi:10.1111/bjc.70077
Usefulness of the Berlin Questionnaire for Screening Patients With Obstructive Sleep Apnea
Yang, H., & Yoo, S. (2022) · Journal of Sleep Medicine · doi:10.13078/jsm.220020
Murri, M. B., Garza, C. K., Grassi, L. G., & Muskin, P. R. (2023) · Springer eBooks · doi:10.1007/978-3-030-42825-9_113-1 · Cited by 1
Behavioural Treatment Considerations for Insomnia: a Review of Meta-analyses
Pal, A., Basu, A., & Gupta, R. M. (2023) · Current Sleep Medicine Reports · doi:10.1007/s40675-023-00264-7
“In order to investigate the effectiveness of CBTi in improvement of the daytime symptoms, Rucker et al. [17] conducted a meta-analysis of 86 studies (15,578 participants).”
BackgroundComparative study on treatment strategies for insomnia
Yang, Y. (2023) · Theoretical and Natural Science · doi:10.54254/2753-8818/15/20240437
Zhao, C., Liu, Y., Roberts, N. P., Lai, L., Zhang, L., Ren, X., Sun, M., & Ren, Z. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.4774469
Attridge, M. D. (2024) · Qeios · doi:10.32388/4ys33s.3
“Cognitive behavioral therapy for insomnia has been shown to lower rates of depression recurrence [87][88] .”
Peersmann, S. H. M. (2024) · doi:10.5463/thesis.886
Clinical Symptoms and Quality of Life: Insomnia and Muscle/Joint Aches
Blümel, J. E., Vallejo, M. S., & Arteaga, E. (2025) · Springer eBooks · doi:10.1007/978-3-031-83979-5_5
Игоревич, Г. М., Evzikov, G. Y., Григорьевич, З. М., Khizhniak, V. V., & Shaykhalov, M. A. (2025) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro202512505287
Sleep and Psychiatric Disorders
Manber, R., Dietch, J. R., Gumport, N. B., & Simpson, N. S. (2025) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197602751.013.28
Cognitive Behavioral Therapies for Insomnia
Morin, C. M., & Kyle, S. D. (2025) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197602751.013.19
Yupanqui-Lorenzo, D. E., Caycho‐Rodríguez, T., Sánchez‐Villena, A. R., Palao-Loayza, L., Arauco-Lozada, T., Lobos-Rivera, M. E., Cárcamo-Zepeda, E., Sierra, M. I. M., Baños-Chaparro, J., Torales, J. C., et al. (2025) · Suma Psicológica · doi:10.14349/sumapsi.2025.v32.n1.4
Winders, S., Yoo, L., Conley, S., Yang, P.-L., & Kamp, K. (2025) · Clinical Nursing Research · doi:10.1177/10547738251360470
“In other populations, CBT-I decreased daytime symptoms of fatigue, anxiety, and depression (Benz et al., 2020; Redeker et al., 2022).”
Understanding insomnia disorder beyond its subtypes: Psychological profiles of insomnia
Clemente, V., Marques, D. R., & Gomes, A. A. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106867
Adaptations of the Original Model of Cognitive Behavioural Therapy
Davies, J., Salkovskis, P., Laidlaw, K., & Beck, J. S. (2025) · Cambridge University Press eBooks · doi:10.1017/9781009090940.010
翁, 振. (2026) · Traditional Chinese Medicine · doi:10.12677/tcm.2026.151042
Efficacy of transdiagnostic cognitive-behavioral treatment for anxiety disorders on insomnia
Provencher, M. D., Dubé, L., Norton, P. J., Carrier, N., & Roberge, P. (2026) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2026.103124
Ballesio, A. (2026) · Current Sleep Medicine Reports · doi:10.1007/s40675-026-00353-3
“Several meta-analyses demonstrated the efficacy of in-person and digital CBT-I protocols in improving sleep quality in clinical and non-clinical samples [ 35 – 38 ].”
Integrative oncology approaches to sleep disturbances and insomnia
Schneiderhan, J. R., Bhandiwad, A., Greenblatt, M., & Zhou, E. S. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-30194-0.00053-9
Unnikrishnan, P., Soman, D., Sreedevi, V., Krishnarajabhatt, H. S., Sreelekshmi, R., Menon, P., Frey, L. M., & Thattil, A. J. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1785264
Neural processing of emotional stimuli before and after cognitive behavioural therapy for insomnia
Xu, Z., Schiel, J. E., Petri, R., Konzen, N., Davoodabadi, A., Schmid, S. R., Feige, B., Maier, S., Feige, U., Frase, L., et al. (2026) · Sleep Medicine · doi:10.1016/j.sleep.2026.108964
Ballesio, A., & Rosa, P. L. (2026) · Current Sleep Medicine Reports · doi:10.1007/s40675-026-00372-0 · Cited by 2
Fiori, V., & Ballesio, A. (2026) · Behavioral Sleep Medicine · doi:10.1080/15402002.2026.2674793
Gao, K., Zhao, Y., Zhang, X., Su, K., Jia, J., & Xu, Y. (2026) · Sleep And Breathing · doi:10.1007/s11325-026-03723-x
Schmid, S. R., Blume, C., Ell, J., Konzen, N., Apweiler, M., Feige, B., Fiebich, B. L., Schiel, J. E., Domschke, K., & Spiegelhalder, K. (2026) · Journal of Sleep Research · doi:10.1111/jsr.70357
“However, sleepiness is typically not a primary focus of CBT-I and meta-analytic findings indicate small effect sizes regarding this symptom (Benz et al. 2020).”
Soukupová, L., Janků, K., Hrubý, A., & Kopřivová, J. (2026) · International Journal of Cognitive Behavioral Therapy · doi:10.1007/s41811-026-00286-3
Nie, S., Zhao, Y., Wang, J., Lu, Z., Zou, H., & Zhao, P. (2026) · Journal of Health Psychology · doi:10.1177/13591053261461928
Rad, P., Jozani, M., Zanella, G., Pour, M. S., & Vaezi, R. (2026) · International Conference on Smart Applications, Communications and Networking (SmartNets) · doi:10.1109/smartnets69662.2026.11604881
“This vicious cycle can lead to mental health issues, such as anxiety and depression [5].”
Xu, J., Wang, B., Zhu, W., Song, P., & Ao, H. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1901978
Knutzen, S. M., Christensen, D. S., Neumann, H., Damholdt, M. F., Amidi, A., & Zachariae, R. (2026) · Internet Interventions · doi:10.1016/j.invent.2026.101007
“This effect was slightly smaller than the pooled effect of non-supported self-help internet CBT-I reported by a network meta-analysis ( d = 0.49) (Benz et al., 2020).”
InfluentialÁlvarez-Ruiz-Larrinaga, A., Armenteros, L., Bellido, C., Triguero, L. L., Martı́nez-Raga, J., Pascual, J., & San, L. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1927424
Wang, Y., Xiong, J., Zhang, Q., Wang, Y., Liu, X., Hu, L., & Hu, K. (2026) · Sleep Medicine · doi:10.1016/j.sleep.2026.109322
Metadata
- Authors
- Benz, F., Knoop, T., Ballesio, A., Bacaro, V., Johann, A. F., Rücker, G., Feige, B., Riemann, D., & Baglioni, C.
- Affiliations
- University of Freiburg (DE)
- Sapienza University of Rome (IT)
- Marconi University (IT)
- Corresponding author
- Benz, Fee
- ORCID
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 80
- Pages
- 101873
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W3033016172
- Cited by
- 142
- References
- 61
- Citations by year
- 2026: 21 · 2025: 37 · 2024: 20 · 2023: 30 · 2022: 21 · 2021: 11 · 2020: 2
- FWCI
- 2.33
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, cc-by-nc-nd)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, other-oa)
- Funders
- Bundesministerium für Bildung und Forschung (01KG1703)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- insomnia, cognitive behavioral therapy for insomnia, daytime symptoms, daytime sleepiness, fatigue, depressive symptoms, anxiety, quality of life, daytime functioning, social functioning, self-help intervention, group therapy, individual psychotherapy
- MeSH terms
- Network Meta-Analysis, Adolescent, Adult, Aged, Aged, 80 and over, Anxiety, Cognition, Depression, Fatigue, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Quality of Life, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
