Comparative efficacy of digital cognitive behavioral therapy for insomnia: A systematic review and network meta-analysis

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...

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Bibliographic Details
Published in:Sleep medicine reviews 2022-02, Vol.61, p.101567-101567, Article 101567
Main Authors: Hasan, Faizul, Tu, Yu-Kang, Yang, Chien-Ming, James Gordon, Christopher, Wu, Dean, Lee, Hsin-Chien, Yuliana, Lia Taurussia, Herawati, Lucky, Chen, Ting-Jhen, Chiu, Hsiao-Yean
Format: Article
Language:English
Subjects:
Adult
Adults
Cognitive Behavioral Therapy
Cognitive behavioral therapy for insomnia
Digital CBTi
Humans
Insomnia
Network Meta-Analysis
Polysomnography
Randomized Controlled Trials as Topic
Self Report
Sleep
Sleep Initiation and Maintenance Disorders - therapy
Treatment Outcome
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Summary: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. CRD42020171134.
ISSN:1087-0792
1532-2955
DOI:10.1016/j.smrv.2021.101567