Telemedicine and insomnia: a comprehensive systematic review and meta-analysis
Open accessAbstract
Background Telemedicine has been introduced as a new and effective method in dealing with public health challenges, improving access to health care, and reducing healthcare costs in today's world. Insomnia is the most common sleep disorder that can be managed with cognitive behavioural therapy, however, access to skilled therapists is an issue. Telemedicine improves access to care and thus, it may facilitate management of insomnia. The aim of this study was to assess whether telemedicine can be as effective as traditional in person sleep medicine service for the diagnosis, follow-up, and treatment of insomnia.Methods In this systematic review and meta-analysis, studies related to telemedicine and insomnia were identified and selected, using the keywords of telemedicine, insomnia, sleep disorder, treatment, non-pharmacological treatment. The international databases of Embase, ProQuest, ScienceDirect, Scopus, PubMed and Web of Science (WoS), and Google Scholar were searched without a lower time limit, and until July 12, 2021. Data were analysed within the Comprehensive Meta-Analysis (version 2) software, and the significance level of the test was considered P ˂ 0.05.Results A systematic review of 16 selected studies showed that telemedicine interventions have a positive effect on improving insomnia in different groups. The meta-analysis was performed on 2 studies. Based on the results, CBTI interventions based on telemedicine have a greater effect on improving chronic insomnia than face to face CBTI with an average difference of 2.05 ± 0.66 based on the random effects model. Moreover, the difference between the mean in the telemedicine intervention group and the non-intervention group was 0.65 ± 0.19, which shows the positive effect of the telemedicine intervention.Conclusion The use of telemedicine in treatment of insomnia not only accelerates access to sleep services, but can also improve the efficiency of health services in terms of time and cost, as well as therapeutic effects.
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Previous studies on eCBTi efficacy indicate a medium effect (partial eta-squared = 0.08).
“Based on previous studies on the efficacy of eCBTi (86–92), we expect a partial eta-squared of 0.08 (medium effect); alpha: 0.05; Power: 0.95; number of groups: 2; number of measurements: 3; total sample size: 32, that is, 16 per condition.”
From Sleep disturbances and psychological well-being among military medical doctors of the Swiss Armed Forces: study protocol, rationale and development of a cross-sectional and longitudinal interventional study (2024) · cites this paper as [88]
The section “The effect of interventions on insomnia” reports that telehealth CBT-I significantly reduced insomnia scores, supporting the efficacy premise. The paper does not report a partial eta-squared of 0.08 or classify that value as a medium effect; its meta-analysis reports effects using mean differences instead. Page numbers were not available in our copy. (LLM, conf=0.87)
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- Authors
- Sharafkhaneh, A., Salari, N., Khazaie, S., Ghasemi, H., Darvishi, N., Hosseinian-Far, A., Mohammadi, M., & Khazaie, H.
- Affiliations
- Baylor College of Medicine (US)
- Kermanshah University of Medical Sciences (IR)
- Gerash University of Medical Sciences (IR)
- Corresponding author
- Mohammadi, Masoud
- Khazaie, Habibolah
- ORCID
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2022-02
- Volume
- 90
- Pages
- 117-130
- ISSN
- 1389-9457 (ISSN-L)
- OpenAlex
- W4206980583
- Cited by
- 26
- References
- 54
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 10 · 2022: 2
- FWCI
- 0.80
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- NECTAR - Northampton Electronic Collection of Thesis and Research (University of Northampton) (acceptedVersion)
- NECTAR - Northampton Electronic Collection of Thesis and Research (University of Northampton) (submittedVersion)
- Funders
- Kermanshah University of Medical Sciences
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- telemedicine, insomnia, cognitive behavioral therapy for insomnia, chronic insomnia, non-pharmacological treatment, telehealth intervention
- MeSH terms
- Humans, Sleep Initiation and Maintenance Disorders, Sleep, Time Factors, Cognitive Behavioral Therapy, Telemedicine
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