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Comparative efficacy of digital cognitive behavioral therapy for insomnia: A systematic review and network meta-analysis
Abstract
The comparative efficacy of various approaches of digital cognitive behavioral therapy for insomnia (CBTi) is still unclear. This network meta-analysis explored the comparative efficacy of digital CBTi approaches in adults with insomnia. Four electronic databases were searched from inception to June 27, 2020. Primary outcomes were self-reported total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), and insomnia symptoms; these were measured using sleep diaries or valid questionnaires. A random-effects network meta-analysis in a frequentist framework was used. Fifty-four randomized controlled trials comprising 11,815 participants were included. Compared with usual care, web-based CBTi with a therapist demonstrated significantly longer TST (mean difference [MD]: 23.19 min, 95% confidence interval [CI]: 18.98-27.39 min), shorter SOL (MD: -18.76 min, 95% CI -24.20 to -13.31 min), lower WASO (MD: -31.40 min, 95% CI: -36.26 to -26.55 min), and greater SE (MD: 10.37%, 95% CI: 8.08%-12.65%). The surface under the cumulative ranking curve indicates that web-based CBTi with therapists is most likely to be ranked the highest among all treatments, and thus, this network meta-analysis suggests that such a treatment is the optimal intervention for improving sleep duration and SE as well as the reductions in SOL and WASO. PROSPERO REGISTRATION NUMBER: CRD42020171134.
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“A recent meta-analysis suggested clinician support is preferred when CBT-I is administered digitally. 42”
From Digital Cognitive-Behavioral Therapy for Insomnia in Cancer Survivors: Protocol for a Pragmatic Clinical Trial (2024) · cites this paper as [42]
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Metadata
- Authors
- Hasan, F., Tu, Y.-K., Yang, C.-M., James Gordon, C., Wu, D., Lee, H.-C., Yuliana, L. T., Herawati, L., Chen, T.-J., & Chiu, H.-Y.
- Affiliations
- Taipei Medical University (TW)
- National Taiwan University (TW)
- National Chengchi University (TW)
- Taipei Medical University-Shuang Ho Hospital (TW)
- Taipei Medical University Hospital (TW)
- Kementerian Kesehatan Republik Indonesia (ID)
- Corresponding author
- Chiu, Hsiao-Yean
- ORCID
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2022-02
- Volume
- 61
- Pages
- 101567
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W3214315566
- Cited by
- 137
- References
- 91
- Citations by year
- 2026: 26 · 2025: 38 · 2024: 30 · 2023: 29 · 2022: 13
- FWCI
- 2.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Science and Technology, Taiwan (110-2628-B-038-017)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Keywords
- digital cognitive behavioral therapy for insomnia, insomnia, online therapy, total sleep time, sleep latency, wake after sleep onset, sleep efficiency, sleep duration, insomnia symptoms, treatment efficacy comparison
- MeSH terms
- Adult, Humans, Sleep Initiation and Maintenance Disorders, Sleep, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Polysomnography, Self Report
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