The efficacy of cognitive behavioral therapy for insomnia in adolescents: a systematic review and meta-analysis of randomized controlled trials

ObjectiveThe objective of this systematic review and meta-analysis was to evaluate the overall efficacy of cognitive behavioral therapy for insomnia (CBT-I) in treating insomnia in adolescents, and to examine the efficacy of CBT-I on different sleep-related outcomes in this population.MethodsRandomi...

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Main Authors: Zhengyang Mei, Chenyi Cai, Shulai Luo, Yuanzhuo Zhang, Chifong Lam, Shi Luo
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1413694/full
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author Zhengyang Mei
Chenyi Cai
Shulai Luo
Yuanzhuo Zhang
Chifong Lam
Shi Luo
author_facet Zhengyang Mei
Chenyi Cai
Shulai Luo
Yuanzhuo Zhang
Chifong Lam
Shi Luo
author_sort Zhengyang Mei
collection DOAJ
description ObjectiveThe objective of this systematic review and meta-analysis was to evaluate the overall efficacy of cognitive behavioral therapy for insomnia (CBT-I) in treating insomnia in adolescents, and to examine the efficacy of CBT-I on different sleep-related outcomes in this population.MethodsRandomized controlled trials (RCTs) of CBT-I on insomnia in adolescents were identified using electronic databases and manual searches. The Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess risk of bias in RCTs. A standardized mean difference (SMD) with a 95% confidence interval (CI) was used to combine effect sizes. A sensitivity analysis was performed for each outcome using a stepwise elimination method to assess whether the pooled results were significantly affected by individual studies.ResultsThe analysis included 8 RCTs involving a total of 599 participants. The meta-analysis indicated that marked and statistically significant improvements in insomnia (SMD = −1.06; 95% CI -1.65 to −0.47; p < 0.01), sleep onset latency (SMD = −0.99; 95% CI -1.65 to −0.32; p < 0.01), total sleep time (SMD = 0.50; 95% CI 0.10 to 0.90; p = 0.01), and sleep efficiency (SMD = 0.57; 95% CI 0.26 to 0.87; p < 0.01) were observed at post-treatment time point following CBT-I. At follow-up time point, a statistically significant improvement in insomnia (SMD = −0.79; 95% CI -1.42 to −0.17; p = 0.01) was observed following CBT-I.ConclusionCBT-I was effective in improving insomnia in adolescents and some sleep-related outcomes, including sleep onset latency, total sleep time, and sleep efficiency. CBT-I was characterized by low risk and high therapeutic benefits and could serve as alternative or adjuvant approaches to medication for the treatment of insomnia. Considering the advantages in terms of safety and efficacy, CBT-I should be the preferred intervention for the treatment of insomnia in adolescents.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, CRD42024526102.
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publishDate 2024-11-01
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spelling doaj-art-1f16a4d5958e4919acbdd22b7fd0d13c2024-11-19T14:58:39ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-11-011210.3389/fpubh.2024.14136941413694The efficacy of cognitive behavioral therapy for insomnia in adolescents: a systematic review and meta-analysis of randomized controlled trialsZhengyang Mei0Chenyi Cai1Shulai Luo2Yuanzhuo Zhang3Chifong Lam4Shi Luo5School of Physical Education, Southwest University, Chongqing, ChinaSchool of Physical Education, Southwest University, Chongqing, ChinaSchool of Physical Education, Southwest University, Chongqing, ChinaSchool of Physical Education, Southwest University, Chongqing, ChinaKey Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, ChinaSchool of Physical Education, Southwest University, Chongqing, ChinaObjectiveThe objective of this systematic review and meta-analysis was to evaluate the overall efficacy of cognitive behavioral therapy for insomnia (CBT-I) in treating insomnia in adolescents, and to examine the efficacy of CBT-I on different sleep-related outcomes in this population.MethodsRandomized controlled trials (RCTs) of CBT-I on insomnia in adolescents were identified using electronic databases and manual searches. The Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess risk of bias in RCTs. A standardized mean difference (SMD) with a 95% confidence interval (CI) was used to combine effect sizes. A sensitivity analysis was performed for each outcome using a stepwise elimination method to assess whether the pooled results were significantly affected by individual studies.ResultsThe analysis included 8 RCTs involving a total of 599 participants. The meta-analysis indicated that marked and statistically significant improvements in insomnia (SMD = −1.06; 95% CI -1.65 to −0.47; p < 0.01), sleep onset latency (SMD = −0.99; 95% CI -1.65 to −0.32; p < 0.01), total sleep time (SMD = 0.50; 95% CI 0.10 to 0.90; p = 0.01), and sleep efficiency (SMD = 0.57; 95% CI 0.26 to 0.87; p < 0.01) were observed at post-treatment time point following CBT-I. At follow-up time point, a statistically significant improvement in insomnia (SMD = −0.79; 95% CI -1.42 to −0.17; p = 0.01) was observed following CBT-I.ConclusionCBT-I was effective in improving insomnia in adolescents and some sleep-related outcomes, including sleep onset latency, total sleep time, and sleep efficiency. CBT-I was characterized by low risk and high therapeutic benefits and could serve as alternative or adjuvant approaches to medication for the treatment of insomnia. Considering the advantages in terms of safety and efficacy, CBT-I should be the preferred intervention for the treatment of insomnia in adolescents.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, CRD42024526102.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1413694/fulladolescentscognitive behavioral therapyinsomniasleepmeta-analysis
spellingShingle Zhengyang Mei
Chenyi Cai
Shulai Luo
Yuanzhuo Zhang
Chifong Lam
Shi Luo
The efficacy of cognitive behavioral therapy for insomnia in adolescents: a systematic review and meta-analysis of randomized controlled trials
Frontiers in Public Health
adolescents
cognitive behavioral therapy
insomnia
sleep
meta-analysis
title The efficacy of cognitive behavioral therapy for insomnia in adolescents: a systematic review and meta-analysis of randomized controlled trials
title_full The efficacy of cognitive behavioral therapy for insomnia in adolescents: a systematic review and meta-analysis of randomized controlled trials
title_fullStr The efficacy of cognitive behavioral therapy for insomnia in adolescents: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed The efficacy of cognitive behavioral therapy for insomnia in adolescents: a systematic review and meta-analysis of randomized controlled trials
title_short The efficacy of cognitive behavioral therapy for insomnia in adolescents: a systematic review and meta-analysis of randomized controlled trials
title_sort efficacy of cognitive behavioral therapy for insomnia in adolescents a systematic review and meta analysis of randomized controlled trials
topic adolescents
cognitive behavioral therapy
insomnia
sleep
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1413694/full
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