Objectives/Introduction: Patients with insomnia disorder often use Complementary and Alternative Interventions (CAI) as over‐thecounter (OTC) antihistamines, aromatherapy, foot reflexology, homeopathy, meditative movement therapies, moxibustion, music therapy and yoga. The National Institute of Health (NIH, 2005) convened that there is insufficient evidence to support these interventions. The aim of this study was to evaluate the efficacy of CAIs through a systematic review and network meta‐analysis of randomized trials . Methods: PubMed, CINHAL, PsycInfo, and PsycArticles were searched from 1980 to End 2015. Twenty‐seven randomized control trials were included evaluating CAI's efficacy in patients with insomnia disorder according to international diagnostic criteria. Six classes of treatment (dietary supplements, exercise, light, melatonin, mindfulness, valerian) and two classes of control conditions (waiting list, placebo) were identified in the network. Risk of biases was assessed through a checklist based on the Cochrane Collaboration′s tool. Outcomes were grouped in two main concepts: subjective sleep quality (based on sleep efficiency index reported in sleep diaries or, if this was not available, questionnaires) and objective sleep quality (based on sleep efficiency index obtained through polysomnography or, if this was not available, actigraphy). Cohen′s d at 95% confidence interval (CI) was calculated to assess the effect sizes of each treatment class as compared with waiting list. Results: Risk of bias assessment indicated a possible high risk of selection bias in our sample of studies. No significant effect was found for any of the six CAI treatment evaluated neither on subjective nor objective sleep quality (for all comparisons in the network p > 0.05). Conclusions: We conclude that currently there is insufficient or negative evidence to support CAI intervention for insomnia disorder. There is a call for ameliorating the availability of evidence‐based therapies, as cognitive‐behavior therapy for insomnia. Disclosure: Nothing to disclose.
A systematic review and network meta‐analysis of complementary and alternative interventions for insomnia
Baglioni C;
2018-01-01
Abstract
Objectives/Introduction: Patients with insomnia disorder often use Complementary and Alternative Interventions (CAI) as over‐thecounter (OTC) antihistamines, aromatherapy, foot reflexology, homeopathy, meditative movement therapies, moxibustion, music therapy and yoga. The National Institute of Health (NIH, 2005) convened that there is insufficient evidence to support these interventions. The aim of this study was to evaluate the efficacy of CAIs through a systematic review and network meta‐analysis of randomized trials . Methods: PubMed, CINHAL, PsycInfo, and PsycArticles were searched from 1980 to End 2015. Twenty‐seven randomized control trials were included evaluating CAI's efficacy in patients with insomnia disorder according to international diagnostic criteria. Six classes of treatment (dietary supplements, exercise, light, melatonin, mindfulness, valerian) and two classes of control conditions (waiting list, placebo) were identified in the network. Risk of biases was assessed through a checklist based on the Cochrane Collaboration′s tool. Outcomes were grouped in two main concepts: subjective sleep quality (based on sleep efficiency index reported in sleep diaries or, if this was not available, questionnaires) and objective sleep quality (based on sleep efficiency index obtained through polysomnography or, if this was not available, actigraphy). Cohen′s d at 95% confidence interval (CI) was calculated to assess the effect sizes of each treatment class as compared with waiting list. Results: Risk of bias assessment indicated a possible high risk of selection bias in our sample of studies. No significant effect was found for any of the six CAI treatment evaluated neither on subjective nor objective sleep quality (for all comparisons in the network p > 0.05). Conclusions: We conclude that currently there is insufficient or negative evidence to support CAI intervention for insomnia disorder. There is a call for ameliorating the availability of evidence‐based therapies, as cognitive‐behavior therapy for insomnia. Disclosure: Nothing to disclose.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
