Cited by 676Sleep and related disordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesObstructive Sleep Apnea Research

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Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis

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van Straten, Annemieke, van der Zweerde, Tanja, Kleiboer, Annet, Cuijpers, Pim, Morin, Charles M., Lancee, Jaap·2018·Sleep Medicine Reviews

DOI 10.1016/j.smrv.2017.02.001

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Abstract

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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Influential
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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)
ORCID: van Straten, Annemieke
Kleiboer, Annet
Cuijpers, Pim
Morin, Charles M.
Lancee, Jaap
Venue: Sleep Medicine Reviews
Publisher: Elsevier BV
Published: 2018-04
Volume: 38
Pages: 3-16
ISSN: 1087-0792 (ISSN-L)
DOI: 10.1016/j.smrv.2017.02.001
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: other-oa
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
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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Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis

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