A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Evaluating the Evidence Base of Melatonin, Light Exposure, Exercise, and Complementary and Alternative Medicine for Patients with Insomnia Disorder

Journal of Clinical Medicine

Valeria Bacaro¹  Bernd Feige²  Lukas Frase²  Chiara Baglioni²  Zarina Bostanova²  Dieter Riemann²  Kai Spiegelhalder²  Fee Benz²  Gerta Rücker³  Elisabeth Hertenstein⁴ 

[1] Department of Human Science, Guglielmo Marconi University, 00193 Rome, Italy;Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany;Institute of Medical Biometry and Statistics, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany;University Hospital of Psychiatry and Psychotherapy, University of Bern, 3012 Bern, Switzerland;

关键词: insomnia;    melatonin;    meditative movement therapies;    exercise;    transcranial magnetic resonance;    hypnotherapy;   

DOI  :  10.3390/jcm9061949

来源: DOAJ

【 摘 要 】

Insomnia is a prevalent disorder and it leads to relevant impairment in health-related quality of life. Recent clinical guidelines pointed out that Cognitive-Behavior Therapy for Insomnia (CBT-I) should be considered as first-line intervention. Nevertheless, many other interventions are commonly used by patients or have been proposed as effective for insomnia. These include melatonin, light exposure, exercise, and complementary and alternative medicine. Evaluation of comparable effectiveness of these interventions with first-line intervention for insomnia is however still lacking. We conducted a systematic review and network meta-analysis on the effects of these interventions. PubMed, PsycInfo, PsycArticles, MEDLINE, and CINAHL were systematically searched and 40 studies were included in the systematic review, while 36 were entered into the meta-analysis. Eight network meta-analyses were conducted. Findings support effectiveness of melatonin in improving sleep-onset difficulties and of meditative movement therapies for self-report sleep efficiency and severity of the insomnia disorder. Some support was observed for exercise, hypnotherapy, and transcranial magnetic resonance, but the number of studies for these interventions is still too small. None of the considered interventions received superior evidence to CBT-I, which should be more widely disseminated in primary care.

【 授权许可】

Unknown