Panacea Index Logo

Command Palette

Search for a command to run...

Can mindfulness-based interventions improve outcomes in cognitive-behavioural therapy for chronic insomnia disorder in the general population? Systematic review and meta-analysis.

Clinical psychology & psychotherapy
January 1, 2023
Manuel de Entrambasaguas et al. (4 authors)
Meta-AnalysisSystematic ReviewJournal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to determine if mindfulness-based interventions (MBIs) could be useful as a component of cognitive-behavioral therapy for insomnia (CBT-I) by analyzing their effects on insomnia severity and sleep quality.

Results Summary

MBIs showed a small to medium effect on insomnia severity (nearing significance), a non-significant medium effect on sleep quality, and a small but significant effect on a composite sleep variable. The analysis could not conclusively demonstrate that MBIs positively affected insomnia in the general adult population.

Population

Adults with chronic insomnia disorder (ID).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (4)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Mindfulness-based interventions (MBIs)
decrease
Insomnia Severity Index (ISI)
active control groups in the pretest-posttest period
Δ = 0.44, p = 0.07
had a small to medium effect size on ISI nearing signification
#1
Mindfulness-based interventions (MBIs)
decrease
Pittsburgh Sleep Quality Index (PSQI)
-
Δ = 0.52, p = 0.18
had a medium, non-significant, effect size on PSQI
#2
Mindfulness-based interventions (MBIs)
decrease
composite sleep variable (CSV)
-
Δ = 0.05, p < 0.01
had a significant though small effect size on CSV
#3
Mindfulness-based interventions (MBIs), combined with CBT-I components in some studies
no change
chronic insomnia disorder (ID)
the general adult population
-
could not demonstrate that MBIs positively affected ID
#4
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. 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.

Medical Subject Headings (MeSH)
AdultHumansMindfulnessSleep Initiation and Maintenance DisordersCognitive Behavioral Therapy
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality75/10
Citation Metrics
Total Citations3
Citations/Year1.5
Relative Citation Ratio0.98
NIH Percentile49.4%
Research Impact Scores
APT Score0.25
Weight Score2.49
Normalized Score0.61
Related Supplements
Can mindfulness-based interventions improve outcomes in cogn... | Panacea Index