Staines Alex Catherine, Broomfield Niall, Pass Laura, Orchard Faith, Bridges Jessica
Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK.
School of Psychology, University of Sussex, Brighton, UK.
J Sleep Res. 2022 Feb;31(1):e13451. doi: 10.1111/jsr.13451. Epub 2021 Jul 30.
Research indicates a bidirectional relationship between sleep and anxiety, with findings suggesting anxiety can precede poor sleep and vice versa. Evidence suggests sleep-related thought processes associated with anxiety are involved in the maintenance of insomnia. Previous meta-analyses provide some evidence to suggest cognitive behavioural therapy for insomnia moderately improves anxiety, yet little research has investigated the effect of other sleep interventions on anxiety symptoms. The aim of this meta-analysis was to review whether non-pharmacological sleep interventions have an impact on anxiety symptoms immediately post-intervention. A systematic search of electronic databases was conducted to identify all randomized control trials (RCTs) investigating non-pharmacological sleep interventions that included anxiety symptoms as an outcome. Forty-three RCTs (n = 5945) met full inclusion criteria and were included in a random-effects meta-analysis model. The combined effect size of non-pharmacological sleep interventions on anxiety symptoms was moderate (Hedges' g = -0.38), indicating a reduction in symptoms. Subgroup analyses found a moderate effect for those with additional physical health difficulties (g = -0.46), a moderate effect for those with additional mental health difficulties (g = -0.47) and a moderate effect for those with elevated levels of anxiety at baseline (g = -0.43). A secondary meta-analysis found a large effect of non-pharmacological sleep interventions on sleep-related thought processes (g = -0.92). These findings indicate non-pharmacological sleep interventions are effective in reducing anxiety and sleep-related thought processes, and these effects may be larger in patients with anxiety. This has clinical implications for considering sleep interventions in the treatment of anxiety.
研究表明睡眠与焦虑之间存在双向关系，研究结果表明焦虑可能先于睡眠不佳出现，反之亦然。有证据表明，与焦虑相关的睡眠相关思维过程参与了失眠的维持。以往的荟萃分析提供了一些证据，表明失眠的认知行为疗法可适度改善焦虑，但很少有研究调查其他睡眠干预措施对焦虑症状的影响。本荟萃分析的目的是回顾非药物睡眠干预措施在干预后即刻是否对焦虑症状有影响。我们对电子数据库进行了系统检索，以识别所有调查非药物睡眠干预措施且将焦虑症状作为一项结果的随机对照试验（RCT）。43项RCT（n = 5945）符合全部纳入标准，并被纳入随机效应荟萃分析模型。非药物睡眠干预措施对焦虑症状的合并效应量为中等（Hedges' g = -0.38），表明症状有所减轻。亚组分析发现，对有其他身体健康问题的人有中等效应（g = -0.46），对有其他心理健康问题的人有中等效应（g = -0.47），对基线焦虑水平较高的人有中等效应（g = -0.43）。一项二次荟萃分析发现，非药物睡眠干预措施对与睡眠相关的思维过程有较大影响（g = -0.92）。这些发现表明，非药物睡眠干预措施在减轻焦虑和与睡眠相关的思维过程方面是有效的，而且这些效果在焦虑患者中可能更大。这对于在焦虑症治疗中考虑睡眠干预措施具有临床意义。
