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Cited by 1,053Sleep and related disordersObstructive Sleep Apnea ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The DOI matches its Crossref record; 103 of the 103 references it cites were found in a registry or an index.

Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis

Trauer, James M., Qian, Mary Y., Doyle, Joseph S., Rajaratnam, Shantha M.W., Cunnington, David·2015·Annals of Internal Medicine
DOI 10.7326/m14-2841
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Abstract

BACKGROUND: Because psychological approaches are likely to produce sustained benefits without the risk for tolerance or adverse effects associated with pharmacologic approaches, cognitive behavioral therapy for insomnia (CBT-i) is now commonly recommended as first-line treatment for chronic insomnia. PURPOSE: To determine the efficacy of CBT-i on diary measures of overnight sleep in adults with chronic insomnia. DATA SOURCES: Searches of MEDLINE, EMBASE, PsycINFO, CINAHL, the Cochrane Library, and PubMed Clinical Queries from inception to 31 March 2015, supplemented with manual screening. STUDY SELECTION: Randomized, controlled trials assessing the efficacy of face-to-face, multimodal CBT-i compared with inactive comparators on overnight sleep in adults with chronic insomnia. Studies of insomnia comorbid with medical, sleep, or psychiatric disorders were excluded. DATA EXTRACTION: Study characteristics, quality, and data were assessed independently by 2 reviewers. Main outcome measures were sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE%). DATA SYNTHESIS: Among 292 citations and 91 full-text articles reviewed, 20 studies (1162 participants [64% female; mean age, 56 years]) were included. Approaches to CBT-i incorporated at least 3 of the following: cognitive therapy, stimulus control, sleep restriction, sleep hygiene, and relaxation. At the posttreatment time point, SOL improved by 19.03 (95% CI, 14.12 to 23.93) minutes, WASO improved by 26.00 (CI, 15.48 to 36.52) minutes, TST improved by 7.61 (CI, -0.51 to 15.74) minutes, and SE% improved by 9.91% (CI, 8.09% to 11.73%). Changes seemed to be sustained at later time points. No adverse outcomes were reported. LIMITATION: Narrow inclusion criteria limited applicability to patients with comorbid insomnia and other sleep problems, and accuracy of estimates at later time points was less clear. CONCLUSION: CBT-i is an effective treatment for adults with chronic insomnia, with clinically meaningful effect sizes. PRIMARY FUNDING SOURCE: None. (PROSPERO registration number: CRD42012002863).

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Research works printed but not linked: 3

  1. Charles J, 2009, Aust Fam Physician, 38, 283
  2. Montgomery P, 2003, Cochrane Database Syst Rev, CD003161
  3. Spielman AJ, 1987, Sleep, 10, 45

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Metadata

Authors
Trauer, J. M., Qian, M. Y., Doyle, J. S., Rajaratnam, S. M. W., & Cunnington, D.
Affiliations
Burnet Institute (AU)
ORCID
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
2015-08-04
Volume
163
Issue
3
Pages
191-204
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/m14-2841
OpenAlex
W1937224863
Cited by
1,053
References
100
Citations by year
2026: 119 · 2025: 120 · 2024: 102 · 2023: 99 · 2022: 122 · 2021: 93 · 2020: 101 · 2019: 96 · 2018: 76 · 2017: 75 · 2016: 45 · 2015: 3
FWCI
8.64
Type
journal article
Language
en
Open access
closed
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
cognitive behavioral therapy for insomnia, chronic insomnia, sleep latency, wake after sleep onset, total sleep time, sleep efficiency, sleep restriction, stimulus control, sleep hygiene, relaxation training
MeSH terms
Chronic Disease, Humans, Sleep Initiation and Maintenance Disorders, Relaxation Therapy, Time Factors, Cognitive Behavioral Therapy

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