Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario, M5T 3M7, Canada; Department of Psychology, Faculty of Science, Memorial University, 232 Elizabeth Avenue, St. John's, Newfoundland, A1B 3X9, Canada.
Department of Psychology, Faculty of Science, Memorial University, 232 Elizabeth Avenue, St. John's, Newfoundland, A1B 3X9, Canada.
Sleep Med Rev. 2022 Jun;63:101615. doi: 10.1016/j.smrv.2022.101615. Epub 2022 Feb 25.
This systematic review and meta-analysis assessed the efficacy of cognitive-behavioural therapy for insomnia (CBT-I) among cancer survivors and explored its effect on comorbid symptoms. Studies were included if they assessed the efficacy of CBT-I in adults diagnosed with cancer published prior to August 2020. The primary outcome was insomnia severity. The protocol was pre-registered on PROSPERO (CRD42020169986). Twenty-two studies met eligibility criteria. CBT-I significantly improved insomnia severity (g = 0.78) with durable benefits at 3- and 6-month follow-up. CBT-I produced significant small to large effects for diary-measured sleep efficiency, wake after sleep onset, total sleep time, sleep onset latency, sleep quality, anxiety, depression, fatigue, and overall quality of life. Subgroup analyses revealed no significant difference between in-person and self-help CBT-I. Overall, CBT-I is a robustly efficacious and durable treatment for insomnia among cancer survivors and can produce concomitant benefits on other symptoms. Implementation efforts are needed to ensure that people with cancer have access to CBT-I as the recommended first-line treatment for insomnia.
本系统评价和荟萃分析评估了认知行为疗法（CBT-I）对癌症幸存者失眠的疗效，并探讨了其对合并症状的影响。如果研究评估了在 2020 年 8 月之前诊断出患有癌症的成年人的 CBT-I 的疗效，则将其纳入研究。主要结局是失眠严重程度。该方案已在 PROSPERO（CRD42020169986）上预先注册。有 22 项研究符合入选标准。CBT-I 显著改善了失眠严重程度（g=0.78），并在 3 个月和 6 个月的随访中具有持久的益处。CBT-I 对日记测量的睡眠效率、睡眠后觉醒时间、总睡眠时间、入睡潜伏期、睡眠质量、焦虑、抑郁、疲劳和总体生活质量产生了显著的小到中到大的影响。亚组分析显示，面对面和自助 CBT-I 之间没有显著差异。总的来说，CBT-I 是一种针对癌症幸存者失眠的有效且持久的治疗方法，并且可以同时改善其他症状。需要努力实施，以确保癌症患者能够获得 CBT-I，因为 CBT-I 是失眠的推荐一线治疗方法。
