Systematic review of cognitive behavioral therapy for insomnia in patients with cancer / 中华行为医学与脑科学杂志

ABSTRACT

Objective:To evaluate the effectiveness of cognitive behavioral therapy for insomnia treating insomnia in patients with cancer.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). RevMan 5.2 software was used to analyse the literature data that met the inclusion criteria.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. 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.