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Cited by 37

The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index.

Behavioral interventions for improving sleep outcomes in menopausal women: a systematic review and meta-analysis

Lam, Christine M., Hernandez-Galan, Leticia, Mbuagbaw, Lawrence, Ewusie, Joycelyne Efua, Thabane, Lehana, Shea, Alison K.·2022·Menopause
DOI 10.1097/gme.0000000000002051
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Abstract

Importance: Perimenopausal and postmenopausal women commonly report sleep disruption and insomnia. Behavioral interventions may be safe alternatives for patients who are unwilling to begin pharmacological treatments because of adverse effects, contraindications, or personal preference. Objective: The primary objective is to assess the efficacy of behavioral interventions on sleep outcomes among perimenopausal and postmenopausal women, as measured using standardized scales and objective methods (polysomnography, actigraphy). The secondary objective is to evaluate the safety of these methods through occurrence of adverse events. Evidence Review: Searches were performed within MEDLINE (OVID interface, 1946 onward), Embase (OVID interface, 1974 onward), Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Web of Science (Core collection) using a search strategy developed in consultation with a health sciences librarian. Title/abstract and full-text screenings were performed in duplicate, and relevant studies were selected based on inclusion and exclusion criteria set to identify randomized controlled trials evaluating the effects of behavioral interventions on sleep quality. Risk of bias assessments were done using the Cochrane Risk of Bias 2 tool, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of the body of evidence. Data were pooled in a meta-analysis using a random-effects model. Findings: Nineteen articles reporting results from 16 randomized controlled trials were included, representing a total of 2,108 perimenopausal and postmenopausal women. Overall, behavioral interventions showed a statistically significant effect on sleep outcomes (standardized mean difference [SMD], −0.62; 95% confidence interval [CI], −0.88 to −0.35; I 2 = 93.4%). Subgroup analyses revealed that cognitive behavioral therapy (SMD, −0.40; 95% CI, −0.70 to −0.11; I 2 = 72.7%), physical exercise (SMD, −0.57; 95% CI, −0.94 to −0.21; I 2 = 94.0%), and mindfulness/relaxation (SMD, −1.28; 95% CI, −2.20 to −0.37; I 2 = 96.0%) improved sleep, as measured using both subjective (eg, Pittsburg Sleep Quality Index) and objective measures. Low-intensity (SMD, −0.91; 95% CI, −1.59 to −0.24; I 2 = 96.8) and moderate-intensity exercise (SMD, −0.21; 95% CI, −0.34 to −0.08; I 2 = 0.0%) also improved sleep outcomes. No serious adverse events were reported. Overall risk of bias ranged from some concern to serious, and the certainty of the body of evidence was assessed to be of very low quality. Conclusions and Relevance: This meta-analysis provides evidence that behavioral interventions, specifically, cognitive behavioral therapy, physical exercise, and mindfulness/relaxation, are effective treatments for improving sleep outcomes among perimenopausal and postmenopausal women.

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Research works printed but not linked: 39

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Cited by

Metadata

Authors
Lam, C. M., Hernandez-Galan, L., Mbuagbaw, L., Ewusie, J. E., Thabane, L., & Shea, A. K.
Affiliations
  • Department of Biology, McMaster University, Hamilton, Ontario, Canada
  • Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada
Venue
Menopause
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2022-09-06
Volume
29
Issue
10
Pages
1210-1221
ISSN
1072-3714
DOI
10.1097/gme.0000000000002051
Cited by
37
References
16
Language
en

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