Can mindfulness-based interventions improve outcomes in cognitive-behavioural therapy for chronic insomnia disorder in the general population? Systematic review and meta-analysis
Cognitive-behavioural therapy for insomnia (CBT-I) is the recommended first-line therapy for adults with chronic insomnia disorder (ID), which is characterized by hyperarousal. Mindfulness-based interventions (MBIs) are protocols aimed at stress reduction based on non-judgmental attention control in...
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| Veröffentlicht in: | Clinical psychology and psychotherapy 2023-09, Vol.30 (5), p.965-978 |
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| creator | de Entrambasaguas, Manuel Díaz-Silveira, Cintia Burgos-Julián, Francisco A Santed, Miguel A |
| description | Cognitive-behavioural therapy for insomnia (CBT-I) is the recommended first-line therapy for adults with chronic insomnia disorder (ID), which is characterized by hyperarousal. Mindfulness-based interventions (MBIs) are protocols aimed at stress reduction based on non-judgmental attention control in the present moment. However, MBIs have been increasingly used without a clear scientific basis. The objective of this analysis was to examine if MBIs could be useful as a component of the CBT-I therapeutic system through a systematic review and meta-analysis of randomized controlled trials (RCTs) and non-randomized studies (NRS) searched in PubMed, PsycINFO, Cochrane and WoS. The Insomnia Severity Index (ISI) was the primary outcome, while the Pittsburgh Sleep Quality Index (PSQI) and a composite sleep variable (CSV) were secondary outcomes. Thirteen articles corresponding to nine studies (three pragmatic RCTs, three explanatory RCTs and three NRS) were included. The omnibus test found that MBIs had a small to medium effect size on ISI nearing signification when comparing active control groups in the pretest-posttest period [Δ = 0.44, p = 0.07], a medium, non-significant, effect size on PSQI [Δ = 0.52, p = 0.18], and a significant though small effect size on CSV [Δ = 0.05, p |
| doi_str_mv | 10.1002/cpp.2874 |
| format | Article |
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Systematic review and meta-analysis</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>de Entrambasaguas, Manuel ; Díaz-Silveira, Cintia ; Burgos-Julián, Francisco A ; Santed, Miguel A</creator><creatorcontrib>de Entrambasaguas, Manuel ; Díaz-Silveira, Cintia ; Burgos-Julián, Francisco A ; Santed, Miguel A</creatorcontrib><description>Cognitive-behavioural therapy for insomnia (CBT-I) is the recommended first-line therapy for adults with chronic insomnia disorder (ID), which is characterized by hyperarousal. Mindfulness-based interventions (MBIs) are protocols aimed at stress reduction based on non-judgmental attention control in the present moment. However, MBIs have been increasingly used without a clear scientific basis. The objective of this analysis was to examine if MBIs could be useful as a component of the CBT-I therapeutic system through a systematic review and meta-analysis of randomized controlled trials (RCTs) and non-randomized studies (NRS) searched in PubMed, PsycINFO, Cochrane and WoS. The Insomnia Severity Index (ISI) was the primary outcome, while the Pittsburgh Sleep Quality Index (PSQI) and a composite sleep variable (CSV) were secondary outcomes. Thirteen articles corresponding to nine studies (three pragmatic RCTs, three explanatory RCTs and three NRS) were included. The omnibus test found that MBIs had a small to medium effect size on ISI nearing signification when comparing active control groups in the pretest-posttest period [Δ = 0.44, p = 0.07], a medium, non-significant, effect size on PSQI [Δ = 0.52, p = 0.18], and a significant though small effect size on CSV [Δ = 0.05, p < 0.01]. No heterogeneity was found. The analysis could not demonstrate that MBIs, combined with CBT-I components in some studies, positively affected ID in the general adult population. This was probably due to the lack of pragmatic designs and suitable measuring instruments. Recommendations are made for designing further studies to address these issues.</description><identifier>ISSN: 1063-3995</identifier><identifier>EISSN: 1099-0879</identifier><identifier>DOI: 10.1002/cpp.2874</identifier><identifier>PMID: 37271575</identifier><language>eng</language><publisher>England: John Wiley and Sons, Limited</publisher><subject>Behavior modification ; Cognitive ability ; Cognitive behavioral therapy ; Insomnia ; Meta-analysis ; Mindfulness ; Sleep disorders ; Systematic review</subject><ispartof>Clinical psychology and psychotherapy, 2023-09, Vol.30 (5), p.965-978</ispartof><rights>2023 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.</rights><rights>2023. 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Systematic review and meta-analysis</title><title>Clinical psychology and psychotherapy</title><addtitle>Clin Psychol Psychother</addtitle><description>Cognitive-behavioural therapy for insomnia (CBT-I) is the recommended first-line therapy for adults with chronic insomnia disorder (ID), which is characterized by hyperarousal. Mindfulness-based interventions (MBIs) are protocols aimed at stress reduction based on non-judgmental attention control in the present moment. However, MBIs have been increasingly used without a clear scientific basis. The objective of this analysis was to examine if MBIs could be useful as a component of the CBT-I therapeutic system through a systematic review and meta-analysis of randomized controlled trials (RCTs) and non-randomized studies (NRS) searched in PubMed, PsycINFO, Cochrane and WoS. The Insomnia Severity Index (ISI) was the primary outcome, while the Pittsburgh Sleep Quality Index (PSQI) and a composite sleep variable (CSV) were secondary outcomes. Thirteen articles corresponding to nine studies (three pragmatic RCTs, three explanatory RCTs and three NRS) were included. The omnibus test found that MBIs had a small to medium effect size on ISI nearing signification when comparing active control groups in the pretest-posttest period [Δ = 0.44, p = 0.07], a medium, non-significant, effect size on PSQI [Δ = 0.52, p = 0.18], and a significant though small effect size on CSV [Δ = 0.05, p < 0.01]. No heterogeneity was found. The analysis could not demonstrate that MBIs, combined with CBT-I components in some studies, positively affected ID in the general adult population. This was probably due to the lack of pragmatic designs and suitable measuring instruments. 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Systematic review and meta-analysis</atitle><jtitle>Clinical psychology and psychotherapy</jtitle><addtitle>Clin Psychol Psychother</addtitle><date>2023-09-01</date><risdate>2023</risdate><volume>30</volume><issue>5</issue><spage>965</spage><epage>978</epage><pages>965-978</pages><issn>1063-3995</issn><eissn>1099-0879</eissn><abstract>Cognitive-behavioural therapy for insomnia (CBT-I) is the recommended first-line therapy for adults with chronic insomnia disorder (ID), which is characterized by hyperarousal. Mindfulness-based interventions (MBIs) are protocols aimed at stress reduction based on non-judgmental attention control in the present moment. However, MBIs have been increasingly used without a clear scientific basis. 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| subjects | Behavior modification Cognitive ability Cognitive behavioral therapy Insomnia Meta-analysis Mindfulness Sleep disorders Systematic review |
| title | Can mindfulness-based interventions improve outcomes in cognitive-behavioural therapy for chronic insomnia disorder in the general population? Systematic review and meta-analysis |
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