Treatment effect heterogeneity of cognitive behavioral therapy for insomnia – A meta-analysis

IF 11.2 1区 医学 Q1 CLINICAL NEUROLOGY Sleep Medicine Reviews Pub Date : 2024-05-31 DOI:10.1016/j.smrv.2024.101966
Lisa Steinmetz , Laura Simon , Harald Baumeister , Kai Spiegelhalder , Yannik Terhorst
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Abstract

Investigation of the heterogeneity of the treatment effect (HTE) might guide the optimization of cognitive behavioral therapy for insomnia (CBT-I). This study examined HTE in CBT-I thereby analyzing if treatment setting, control group, different CBT-I components, and patient characteristics drive HTE. Randomized controlled trials investigating CBT-I were included. Bayesian random effect meta-regressions were specified to examine variances between the intervention and control groups regarding post-treatment symptom severity. Subgroup analyses analyzing treatment setting and control groups and covariate analysis analyzing treatment components and patient characteristics were specified. No significant HTE in CBT-I was found for the overall data set, settings and control groups. The covariate analyses yielded significant results for baseline severity and the treatment component relaxation therapy. Thus, this study identified potential causes for HTE in CBT-I for the first time, showing that it might be worthwhile to further examine possibilities for precision medicine in CBT-I.

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认知行为疗法治疗失眠的疗效异质性 - 一项荟萃分析
对治疗效果异质性(HTE)的研究可能会指导失眠认知行为疗法(CBT-I)的优化。本研究对 CBT-I 的 HTE 进行了研究,从而分析治疗环境、对照组、CBT-I 的不同组成部分以及患者特征是否会影响 HTE。研究纳入了研究 CBT-I 的随机对照试验。通过贝叶斯随机效应元回归,研究了干预组和对照组在治疗后症状严重程度方面的差异。此外,还对治疗环境和对照组进行了分组分析,并对治疗内容和患者特征进行了协变量分析。在整个数据集、治疗环境和对照组中,CBT-I 均未发现明显的 HTE。协变量分析结果显示,基线严重程度和放松疗法的治疗成分具有显著性。因此,本研究首次发现了 CBT-I 中 HTE 的潜在原因,表明在 CBT-I 中进一步研究精准医疗的可能性是值得的。
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来源期刊
Sleep Medicine Reviews
Sleep Medicine Reviews 医学-临床神经学
CiteScore
20.10
自引率
3.80%
发文量
107
期刊介绍: Sleep Medicine Reviews offers global coverage of sleep disorders, exploring their origins, diagnosis, treatment, and implications for related conditions at both individual and public health levels. Articles comprehensively review clinical information from peer-reviewed journals across various disciplines in sleep medicine, encompassing pulmonology, psychiatry, psychology, physiology, otolaryngology, pediatrics, geriatrics, cardiology, dentistry, nursing, neurology, and general medicine. The journal features narrative reviews, systematic reviews, and editorials addressing areas of controversy, debate, and future research within the field.
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