Effects of different interventions on insomnia in adults: Systematic review and network meta-analysis

Author: Shuwen Wang1, Yueyan Lan1, Zixiu Liu1, Shuang Xu2, Xiaomei Wu3
Affiliation: <sup>1</sup> Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China. <sup>2</sup> Library of China Medical University, Shenyang, Liaoning Province, China. <sup>3</sup> Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China. Electronic address: xiaomeiwu@cmu.edu.cn.
Conference/Journal: J Psychiatr Res
Date published: 2023 Jul 23
Other: Volume ID: 165 , Pages: 140-149 , Special Notes: doi: 10.1016/j.jpsychires.2023.07.004. , Word Count: 229


Objective:
Insomnia is a common sleep disorder. There are many clinical-intervention methods for treating this condition, but thus far, the most effective method has not been determined.

Methods:
We conducted a network meta-analysis by including random evidence of insomnia improvement in people over 18 years old, without other physical diseases. From January 1, 1990 to June 15, 2022, we searched multiple electronic databases for randomized controlled trials of different insomnia-related, clinical-intervention methods. R software was used to analyze 10 indices, in order to evaluate the effect of sleep improvement. Primary outcomes comprised Pittsburgh sleep quality-index (PSQI) scores and insomnia severity-index (ISI) scores.

Results:
Finally, 122 randomized controlled trials were included in our study. For the PSQI scores, we found the sequence of intervention measures by effect to be as follows: electroacupuncture, acupuncture, repetitive transcranial magnetic stimulation (rTMS), essential oils, herbal medicine, traditional Western medicine, Tai Chi and Baduanjin, music, supplements, cognitive behavioral therapy for insomnia (CBT-I), and exercise. The results for ISI were similar to those for PSQI, but with slight differences.

Conclusion:
Our research results indicate that various measures have a certain effect on improving sleep, among which the effect of instruments is more prominent. The curative effect of placebo groups was better than that of blank control groups. There is essentially no statistical difference in detailed classification within the same intervention category.

Keywords: Insomnia; Network meta-analysis; PSQI; Sleep disorder; Treatment.

PMID: 37499485 DOI: 10.1016/j.jpsychires.2023.07.004