Wang Xiang, Li Peihuan, Pan Chen, Dai Lisha, Wu Yan, Deng Yunlong
Department of Clinical Psychology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China.
Psychosomatic Health Institute, the Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, China.
Evid Based Complement Alternat Med. 2019 Feb 13;2019:9359807. doi: 10.1155/2019/9359807. eCollection 2019.
BACKGROUND/PURPOSE: Sleep plays an important role in individuals' health. The functions of the brain, the cardiovascular system, the immune system, and the metabolic system are closely associated with sleep. As a prevalent sleep disorder, insomnia has been closely concerned, and it is necessary to find effective therapies. In recent years, a growing body of studies has shown that mind-body therapies (MBTs) can improve sleep quality and ameliorate insomnia severity. However, a comprehensive and overall systematic review has not been conducted. In order to examine the effect of MBTs on insomnia, we conducted a systematic review and meta-analysis evaluating the effects of MBTs on sleep quality in healthy adults and clinical populations.
PubMed, EMBASE, the Cochrane Library, and review of references were searched up to July 2018. English language studies of all designs evaluating the effect of MBTs on sleep outcomes in adults with or without diseases were examined. To calculate the SMDs and 95% CIs, we used a fixed effect model when heterogeneity was negligible and a random effect model when heterogeneity was significant.
49 studies covering 4506 participants published between 2004 and 2018 were identified. Interventions included meditation, tai chi, qigong, and yoga which lasted 4 to 24 weeks. The MBTs resulted in statistically significant improvement in sleep quality and reduction on insomnia severity but no significant effects on sleep quantity indices, which were measured by sleep diary or objective measures. We analyzed the effects of tai chi and qigong separately as two different MBTs for the first time and found that qigong had a slight advantage over tai chi in the improvement of sleep quality. Subgroup analyses revealed that the effect of MBTs on sleep quality in healthy individuals was larger than clinical populations. The effect of MBTs might be influenced by the intervention duration but not the frequency.
MBTs can be effective in treating insomnia and improving sleep quality for healthy individuals and clinical patients. More high-quality and well-controlled RCTs are needed to make a better conclusion in further study.
背景/目的：睡眠在个体健康中起着重要作用。大脑、心血管系统、免疫系统和代谢系统的功能都与睡眠密切相关。失眠作为一种常见的睡眠障碍，一直备受关注，因此有必要寻找有效的治疗方法。近年来，越来越多的研究表明，身心疗法（MBTs）可以改善睡眠质量，减轻失眠严重程度。然而，尚未进行全面且系统的综述。为了研究身心疗法对失眠的影响，我们进行了一项系统综述和荟萃分析，以评估身心疗法对健康成年人及临床人群睡眠质量的影响。
检索截至2018年7月的PubMed、EMBASE、Cochrane图书馆以及参考文献综述。纳入所有评估身心疗法对患有或未患疾病的成年人睡眠结果影响的英文研究。为计算标准化均数差（SMDs）和95%可信区间（CIs），当异质性可忽略不计时，我们使用固定效应模型；当异质性显著时，则使用随机效应模型。
共纳入49项研究，涉及2004年至2018年间发表的4506名参与者。干预措施包括冥想、太极拳、气功和瑜伽，持续时间为4至24周。身心疗法在睡眠质量改善和失眠严重程度降低方面具有统计学显著意义，但对通过睡眠日记或客观测量指标衡量的睡眠数量指标没有显著影响。我们首次将太极拳和气功作为两种不同的身心疗法分别分析其效果，发现气功在改善睡眠质量方面比太极拳略有优势。亚组分析显示，身心疗法对健康个体睡眠质量的影响大于临床人群。身心疗法的效果可能受干预持续时间影响，但不受频率影响。
身心疗法对健康个体和临床患者治疗失眠及改善睡眠质量可能有效。需要更多高质量且严格控制的随机对照试验来在进一步研究中得出更好的结论。
