Is cognitive behavioral therapy for insomnia effective for improving sleep duration in individuals with insomnia? A meta-analysis of randomized controlled trials
Open accessAbstract
BACKGROUND: Accumulating evidence suggests that sleep duration is a critical determinant of physical and mental health. Half of the individuals with chronic insomnia report less than optimal sleep duration. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for reducing sleep difficulties in individuals with chronic insomnia. However, its effectiveness for increasing sleep duration is less well-established and a synthesis of these findings is lacking. PURPOSE: To provide a synthesis of findings from randomized controlled trials (RCTs) on the effect of CBT-I on subjective and objective total sleep time (TST). METHODS: A systematic search was performed on articles published from 2004 to 05/30/2021. A total of 43 RCTs were included in the meta-analysis. Publication biases were examined. Meta-regressions were conducted to examine if any sample or treatment characteristics moderated the effect sizes across trials. RESULTS: We found a small average effect of CBT-I on diary-assessed TST at post-treatment, equivalent to an approximately 30-min increase. Age significantly moderated the effects of CBT-I on diary-measured and polysomnography-measured TST; older ages were associated with smaller effect sizes. Contrarily, a negative, medium effect size was found for actigraphy-assessed TST, equivalent to an approximately 30-min decrease. Publication biases were found for diary data at follow-up assessments suggesting that positive findings were favored. CONCLUSIONS: CBT-I resulted in improvements in TST measured by sleep diaries and polysomnography (in adults). These improvements were not corroborated by actigraphy findings. Theoretical and clinical implications were discussed.
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An inverse association with age has also been found in studies on CBT-I with noncancer samples and in studies on psychotherapy for depression.
“This inverse association with age has also been found in studies on CBT-I with noncancer samples (113) and in studies on psychotherapy for depression (114).”
From Interventions for insomnia in cancer patients and survivors-a comprehensive systematic review and meta-analysis (2024) · cites this paper as [113]
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Clinical Symptoms and Quality of Life: Insomnia and Muscle/Joint Aches
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Mit KVT-I und Medikation gegen primäre Insomnie
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- Authors
- Chan, W. S., McCrae, C. S., & Ng, A. S.-Y.
- Affiliations
- University of Hong Kong (HK)
- University of Missouri (US)
- Corresponding author
- Chan, Wai Sze
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-12-03
- Volume
- 57
- Issue
- 6
- Pages
- 428-441
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- OpenAlex
- W4310640724
- Cited by
- 20
- References
- 86
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 4 · 2023: 3
- FWCI
- 0.47
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion, cc-by-nc-nd)
- 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 › Obstructive Sleep Apnea Research
- Keywords
- cognitive behavioral therapy for insomnia, chronic insomnia, sleep duration, total sleep time, sleep diary, polysomnography, actigraphy, age as moderator, publication bias, treatment effectiveness
- MeSH terms
- Sleep Duration, Adult, Humans, Sleep Initiation and Maintenance Disorders, Sleep, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome, Polysomnography
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