Systematic review and meta-analysis of cognitive-behavioural therapy for insomnia on subjective and actigraphy-measured sleep and comorbid symptoms in cancer survivors.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of clinical trials.
PubMed 35303692 · doi:10.1016/j.smrv.2022.101615
What was done
A pre-registered systematic review and meta-analysis (PROSPERO CRD42020169986) evaluated the efficacy of cognitive-behavioural therapy for insomnia (CBT-I) in adult cancer survivors across studies published before August 2020. The primary outcome was insomnia severity; diary-measured sleep parameters and comorbid symptoms (anxiety, depression, fatigue, quality of life) were also evaluated across 22 included studies.
What was found
CBT-I significantly reduced insomnia severity (Hedges' g = 0.78) with durable effects at 3- and 6-month follow-up. CBT-I produced statistically significant small-to-large effects on diary-measured sleep efficiency, wake after sleep onset, total sleep time, sleep onset latency, sleep quality, anxiety, depression, fatigue, and quality of life. Subgroup analysis showed no significant difference in efficacy between in-person and self-help CBT-I. Exact point estimates and confidence intervals for secondary outcomes and actigraphy were not reported in the abstract.
Why it matters
This review reinforces CBT-I as a durable, multi-symptom intervention for cancer survivors with insomnia. The equivalent efficacy found for self-help delivery supports scalable, accessible alternatives to clinician-delivered therapy.
Limits
The abstract does not report the total participant count, study designs (randomized vs non-randomized), risk of bias, or statistical heterogeneity. Actigraphy-measured sleep outcomes mentioned in the title are not quantified or described in the abstract text.
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- supports Cognitive Behavioral Therapy for Insomnia (CBT-I) is effective for treating insomnia in people with chronic pain, fibromyalgia, and cancer.