![]() ![]() The most common approach to the management of insomnia is medication treatment. In addition, there is evidence that insomnia may confer risk for medical illness including hypertension, heart disease, and diabetes, and is associated with increased overall health care costs. Insomnia is independently associated with significant morbidity including fatigue, impaired concentration and memory, irritability, difficulty in interpersonal relationships, decreased quality of life, and increased risk of new-onset psychiatric illness. ![]() There is now evidence to suggest that insomnia often persists following resolution of these ‘primary’ conditions, and that it generally does not spontaneously resolve over time if left untreated. ![]() In the past insomnia was considered to be a symptom of these conditions with the assumption that treatment of these ‘primary’ conditions would lead to the resolution of insomnia, eliminating the need for targeted insomnia treatment. Insomnia can exist as a primary disorder or co-morbid with other conditions including depression and chronic pain. The prevalence of insomnia in primary care patients is as high as 69% compared to 33% in the general population. Primary care providers should consider CBT-I as a first-line treatment option for insomnia. ConclusionsĬBT-I is effective for treating insomnia when compared with medications, and its effects may be more durable than medications. Very low grade evidence supports use of CBT-I to improve psychological outcomes. Low to moderate grade evidence suggests CBT-I has superior effectiveness to benzodiazepine and non-benzodiazepine drugs in the long term, while very low grade evidence suggests benzodiazepines are more effective in the short term. Resultsįive studies met criteria for analysis. Evidence base quality was assessed using GRADE. Extracted results included quantitative sleep outcomes, as well as psychological outcomes and adverse effects when available. sleep latency) in order to be included in the analysis. Trials had to report quantitative sleep outcomes (e.g. In accordance with PRISMA guidelines, we systematically reviewed MEDLINE, EMBASE, the Cochrane Central Register, and PsycINFO for randomized controlled trials (RCTs) comparing CBT-I to any prescription or non-prescription medication in patients with primary or comorbid insomnia. A potential alternative to medications is cognitive behavioral therapy for insomnia (CBT-I). Conclusion:CBT-I has a certain effect on the sleep of patients with tumor insomnia.It not only improves the subjective sleep latency, wake time after sleep, sleep efficiency and sleep quality, but also reduces the severity of insomnia and fatigue.However, there was no significant improvement in objective sleep parameters, anxiety, depression and quality of life.Due to the limitations of the quality of the included studies, the conclusions of this study need to be verified by more larger sample and high-quality randomized controlled studies.Insomnia is common in primary care, can persist after co-morbid conditions are treated, and may require long-term medication treatment. Results:A total of 13 studies were included with a total of 1 326 patients, including 741 in the CBT-I group and 585 in the control group.The results of meta-analysis showed that, the subjective sleep latency (MD=-10.69, 95% CI =-14.91-6.48), subjective wake time after sleep onset (MD=-13.68, 95% CI=-19.36-8.00), insomnia severity index (SMD=-1.27, 95% CI=-1.98-0.56) and sleep quality score (SMD=-0.72, 95% CI=-0.90-0.53) in CBT-I group were lower than those in the control group, and the differences were statistically significant.The subjective sleep efficiency (MD=6.98, 95% CI=5.00-8.96) in CBT-I group was higher than that in the control group and the difference was statistically significant.The subjective total sleep time (MD=2.59, 95% CI=-10.43-15.61), objective sleep latency (MD=-2.66, 95% CI=-5.68-0.35), objective wake time after sleep onset (MD=-2.89, 95% CI=-8.48-2.70), objective total sleep time (MD=-15.26, 95% CI=-31.80-1.28), objective sleep efficiency (MD=0.92, 95% CI=-0.79-2.62), anxiety score(SMD=-0.19, 95% CI=-0.46-0.08)), depression score(SMD=-0.19, 95% CI=-0.46-0.07) and quality of Life score(SMD=0.13, 95% CI=-0.06-0.33) in CBT-I group and control group were not statistically significant. RevMan 5.2 software was used to analyse the literature data that met the inclusion criteria. Methods: PubMed, EMbase, Cochrane Library, PsycINFO, CBM and CNKI databases were searched to collect randomized controlled studies related to the treatment of insomnia patients with cancer with cognitive behavior therapy for insomnia(CBT-I). ABSTRACT Objective:To evaluate the effectiveness of cognitive behavioral therapy for insomnia treating insomnia in patients with cancer. ![]()
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