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Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis
Open accessAbstract
Insomnia is a major public health problem considering its high prevalence, impact on daily life, co-morbidity with other disorders and societal costs. Cognitive behavioral treatment for insomnia (CBTI) is currently considered to be the preferred treatment. However, no meta-analysis exists of all studies using at least one component of CBTI for insomnia, which also uses modern techniques to pool data and to analyze subgroups of patients. We included 87 randomized controlled trials, comparing 118 treatments (3724 patients) to non-treated controls (2579 patients). Overall, the interventions had significant effects on: insomnia severity index (g = 0.98), sleep efficiency (g = 0.71), Pittsburgh sleep quality index (g = 0.65), wake after sleep onset (g = 0.63) and sleep onset latency (SOL; g = 0.57), number of awakenings (g = 0.29) and sleep quality (g = 0.40). The smallest effect was on total sleep time (g = 0.16). Face-to-face treatments of at least four sessions seem to be more effective than self-help interventions or face-to-face interventions with fewer sessions. Otherwise the results seem to be quite robust (similar for patients with or without comorbid disease, younger or older patients, using or not using sleep medication). We conclude that CBTI, either its components or the full package, is effective in the treatment of insomnia.
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“…improving subjective sleep quality ( g = 0.65) and sleep metrics, including sleep efficiency (SE%; g = 0.71), total sleep time (TST; g = 0.16), wake after sleep onset (WASO; g = 0.63), sleep-onset latency (SOL; g = 0.57) and number of nocturnal awakenings ( g = 0.29; van Straten et al., 2018).”
InfluentialAndersen, S. G., Sæterhagen, H., Pacheco, A. P., Pripp, A. H., Hrubos‐Strøm, H., Papageorgiou, C., Munkhaugen, J., & Dammen, T. (2025) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.11656 · Cited by 13
“21,24,25 Wu et al 21 conducted a meta-analysis of CBT-I for insomnia comorbid with psychiatric and medical conditions and reported that CBT-I was effective in improving insomnia symptoms and sleep parameters for those with comorbid conditions, and van Straten et al 19 observed similar effectiveness in reducing insomni…”
InfluentialA single‐case multiple baseline design for treating insomnia in eating disorders: The TIRED study
Christensen, K. A., Forbush, K. T., Elliott, B. T., & Jarmolowicz, D. P. (2020) · International Journal of Eating Disorders · doi:10.1002/eat.23450 · Cited by 12
“CBT-I has moderate-to-large short-term effects on insomnia severity and sleep efficiency (van Straten et al., 2018), with effects persisting at three, six, and 12 months post-treatment (Van Der Zweerde, Bisdounis, Kyle, Lancee, & Van Straten, 2019) and small effects on depressive symptoms (Ho,…”
BackgroundStenberg, J., Ritola, V., Joffe, G., Saarni, S. E., & Rosenström, T. H. (2022) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.10186 · Cited by 13
Subjective sleep‐related variables in those who have and have not experienced sleep paralysis
Denis, D., French, C. C., Schneider, M. N., & Gregory, A. M. (2017) · Journal of Sleep Research · doi:10.1111/jsr.12650 · Cited by 11
“CBT is highly effective in treating insomnia (van Straten et al., 2017).”
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Treatment of chronic insomnia in adults
Clarke, K., Orlov, N. M., & Soong, C. (2024) · Canadian Family Physician · doi:10.46747/cfp.7003176 · Cited by 12
Linardon, J., Anderson, C., McClure, Z., Liu, C., & Messer, M. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.08.025 · Cited by 13
Effects of exercise on sleep quality in women — A systematic review and meta-analysis
Qiao, Y., Wang, C., Chen, Q., & Zhang, P. (2024) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2024.11.015 · Cited by 11
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Min, J., Kim, B., & Park, H. (2021) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2021.101464 · Cited by 12
Lau, P. H., Carney, A. E., Marway, O. S., Carmona, N. E., Amestoy, M. E., & Carney, C. E. (2022) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2022.100366 · Cited by 12
Prguda, E., Evans, J., McLeay, S. C., Romaniuk, M., Phelps, A. J., Lewis, K., Brown, K., Fisher, G., Lowrie, F., Saunders‐Dow, E., et al. (2023) · Journal of Clinical Psychology · doi:10.1002/jclp.23561 · Cited by 11
Yan, D., Wu, Y., Luo, R., & Yang, J. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.07.018 · Cited by 14
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Fox, R. S., Gaumond, J. S., Zee, P. C., Kaiser, K., Tanner, E. J., Ancoli‐Israel, S., Siddique, J., Penedo, F. J., Wu, L. M., Reid, K. J., et al. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.818718 · Cited by 9
Sleep: An Overlooked Lifestyle Factor in Disorders of Gut-Brain Interaction
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Metadata
- Authors
- van Straten, A., van der Zweerde, T., Kleiboer, A., Cuijpers, P., Morin, C. M., & Lancee, J.
- Affiliations
- Amsterdam Public Health (NL)
- Université Laval (CA)
- University of Amsterdam (NL)
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2018-04
- Volume
- 38
- Pages
- 3-16
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W2587695521
- Semantic Scholar
- 6c1b6f5159447dbff310c8cee6eabea911bf3c07
- Cited by
- 676
- References
- 158
- Citations by year
- 2026: 55 · 2025: 100 · 2024: 90 · 2023: 79 · 2022: 79 · 2021: 77 · 2020: 89 · 2019: 58 · 2018: 34
- FWCI
- 8.49
- Type
- journal article
- Language
- en
- Open access
- green
- research.vu.nl
- Licence
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- 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
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- insomnia, cognitive behavioral therapy for insomnia, sleep efficiency, sleep quality, sleep latency, wake after sleep onset, number of awakenings, total sleep time, self-help intervention, number of treatment sessions, comorbid diseases, sleep medication use
- MeSH terms
- Humans, Sleep Initiation and Maintenance Disorders, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic
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