Effects of cognitive behavioral therapy for insomnia (CBT-I) on quality of life: A systematic review and meta-analysis Article Swipe
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· 2022
· Open Access
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· DOI: https://doi.org/10.1016/j.smrv.2022.101646
The effects of cognitive behavioral therapy for insomnia (CBT-I) have consistently been shown to improve insomnia symptoms and other health-related outcomes, but the effects on QoL have been inconsistent. Many factors including the type CBT-I delivery and type of instrument used to assess QoL make the topic complex. The present systematic review and meta-analysis synthesized the evidence of CBT-I efficacy on QoL outcomes across different populations, delivery modes, and methodological aspects. Following the guidelines on preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a literature search was conducted through PubMed, Web of Science, Scopus, and PsycINFO using keywords from relevant MeSH terms based on PICOS (Participants, Intervention, Comparison, Outcome and Study) criteria. Clinical trials investigating the effect of CBT-I as an intervention on QoL with any kind of control group were eligible if they reported mean scores and variation of QoL. Meta-analysis using a random-effect model was conducted to calculate the standardized mean differences (SMDs) in a set including all identified studies, as well as in three sub-sets: face-to-face CBT-I using randomized controlled trials (RCTs), online CBT-I using RCTs, and one-group pre- and post-treatment design. A total of 24 studies comprising 1977 participants (808 in an intervention group) from 12 countries were eligible for meta-analysis. The overall pooled estimate of SMD of QoL when all 24 studies were included was 0.47 (95% CI: 0.22; 0.72; I2 = 84.5%; tau2 = 0.31; p < 0.001). The overall pooled estimate of SMD of QoL was 0.46 (95% CI: 0.01-0.90; I2 = 87.5%; tau2 = 0.48, p < 0.001) for intervention groups with face-to-face CBT-I compared to controls; 0.47 (95% CI: 0.02-0.92; I2 = 88.3%; tau2 = 0.36; p = 0.04) for intervention groups with digital CBT-I compared to controls, and 0.46 (95% CI: 0.12-0.80; I2 = 52.9%; tau2 = 0.07; p = 0.08) for one-group pre- and post-comparison using CBT-I intervention compared to baseline. Moreover, effects of CBT-I on QoL were different across populations (pooled SMD = 0.59 for patients with insomnia; 0.29 for patients with insomnia comorbid with another major disorder; and 0.48 for other conditions) and types of QoL instruments (pooled SMD = 0.36 for disease-specific QoL instrument not on insomnia, 0.43 for generic QoL instrument, and 0.67 for a single-QoL-item instrument). The probability of publication bias was ruled out in overall and design specific sub-group analysis based on funnel plot and Egger's test. In conclusion, this meta-analysis confirmed a moderate, overall effect of CBT-I in improving QoL. However, due to small power and heterogeneity, future studies are needed to better explore the impact of moderating factors such as mode of delivery and type of QoL measure for assessment used.
Related Topics
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1016/j.smrv.2022.101646
- OA Status
- hybrid
- Cited By
- 134
- References
- 84
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4229460259
Raw OpenAlex JSON
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https://openalex.org/W4229460259Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1016/j.smrv.2022.101646Digital Object Identifier
- Title
-
Effects of cognitive behavioral therapy for insomnia (CBT-I) on quality of life: A systematic review and meta-analysisWork title
- Type
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reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
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2022Year of publication
- Publication date
-
2022-05-10Full publication date if available
- Authors
-
Zainab Alimoradi, Elahe Jafari, Anders Broström, Maurice M. Ohayon, Chung‐Ying Lin, Mark D. Griffiths, Kerstin Blom, Susanna Jernelöv, Viktor Kaldo, Amir H. PakpourList of authors in order
- Landing page
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https://doi.org/10.1016/j.smrv.2022.101646Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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hybridOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1016/j.smrv.2022.101646Direct OA link when available
- Concepts
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Meta-analysis, PsycINFO, Randomized controlled trial, Cognitive behavioral therapy, Systematic review, Quality of life (healthcare), Clinical psychology, MEDLINE, Medicine, Cognition, Intervention (counseling), Insomnia, Physical therapy, Psychology, Psychotherapist, Psychiatry, Internal medicine, Political science, LawTop concepts (fields/topics) attached by OpenAlex
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134Total citation count in OpenAlex
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2025: 61, 2024: 36, 2023: 28, 2022: 8, 2014: 1Per-year citation counts (last 5 years)
- References (count)
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84Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.0.59 | 326 |
| abstract_inverted_index.0.67 | 368 |
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| abstract_inverted_index.0.36; | 275 |
| abstract_inverted_index.0.48, | 253 |
| abstract_inverted_index.0.72; | 225 |
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| abstract_inverted_index.Items | 77 |
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| abstract_inverted_index.RCTs, | 179 |
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| abstract_inverted_index.0.001) | 256 |
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| abstract_inverted_index.Scopus, | 94 |
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| abstract_inverted_index.insomnia | 7, 15, 335 |
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| abstract_inverted_index.different | 64, 320 |
| abstract_inverted_index.disorder; | 340 |
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| abstract_inverted_index.including | 31, 159 |
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| abstract_inverted_index.0.02-0.92; | 269 |
| abstract_inverted_index.0.12-0.80; | 292 |
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