Department of Nursing, Donggang University, Gwangju, Korea.
Department of Nursing, Nambu University, Gwangju, Korea.
BMJ Open. 2022 Nov 4;12(11):e058032. doi: 10.1136/bmjopen-2021-058032.
Mindfulness-based stress reduction (MBSR) is a meditation-based therapy originally recommended for stress management. However, it is currently used to alleviate sleep disturbances. Therefore, this contemporary systematic review aimed to elucidate the clinical effects of MBSR on sleep quality and sleep-related daytime impairment in adults with sleep disturbances, including chronic insomnia disorders.
Systematic review and meta-analysis of randomised controlled trials (RCTs).
A comprehensive search was conducted using the following databases: Ovid MEDLINE, AMED, Ovidembase, PsycINFO, Cochrane Library, CINAHL, and four domestic databases: KoreaMed, KISS, KMbase and NDSL. The final search update was performed in June 2022. Two researchers independently selected relevant studies, assessed the risk of bias and extracted the data.
Of the 7516 records searched, 20 RCTs and 21 reports were included. In the subgroup analysis, MBSR did not improve objective or subjective sleep quality in chronic insomnia and cancers. However, MBSR versus waitlist control might have been effective in improving subjective sleep quality, but with substantial heterogeneity (standardised mean difference=-0.32; 95% CI: -0.56 to -0.08; I=71%). In addition, MBSR compared with active control did not improve the sleep-related daytime impairments including depression, anxiety, stress, fatigue and quality of life. The overall risk of bias included in this review was a concern because of performance and detection bias.
MBSR might be ineffective for improving sleep quality in patients with chronic insomnia and cancers. In addition, more than half of the RCTs included in this review had small sample sizes and were vulnerable to performance and detection biases. Therefore, well-designed RCTs with larger sample sizes are required to confirm the clinical effects of MBSR in adults with sleep disturbances.
CRD42015027963.
正念减压（MBSR）是一种基于冥想的疗法，最初被推荐用于压力管理。然而，它目前被用于缓解睡眠障碍。因此，本当代系统评价旨在阐明 MBSR 对有睡眠障碍的成年人的睡眠质量和与睡眠相关的日间损害的临床效果，包括慢性失眠障碍。
随机对照试验（RCT）的系统评价和荟萃分析。
使用以下数据库进行全面检索：Ovid MEDLINE、AMED、Ovidembase、PsycINFO、Cochrane 图书馆、CINAHL 以及四个国内数据库：KoreaMed、KISS、KMbase 和 NDSL。最终搜索更新于 2022 年 6 月进行。两名研究人员独立选择相关研究，评估偏倚风险并提取数据。
在搜索到的 7516 条记录中，纳入了 20 项 RCT 和 21 份报告。在亚组分析中，MBSR 并没有改善慢性失眠和癌症患者的客观或主观睡眠质量。然而，MBSR 与等待对照相比，可能对改善主观睡眠质量有效，但存在很大的异质性（标准化均数差=-0.32；95%CI：-0.56 至-0.08；I=71%）。此外，MBSR 与活性对照相比，不能改善与睡眠相关的日间损害，包括抑郁、焦虑、压力、疲劳和生活质量。由于存在偏倚风险，本综述中纳入的研究整体偏倚风险令人担忧。
MBSR 可能对改善慢性失眠和癌症患者的睡眠质量无效。此外，本综述中纳入的超过一半的 RCT 样本量较小，容易受到偏倚风险的影响。因此，需要设计更好的 RCT 并纳入更大的样本量，以确认 MBSR 在有睡眠障碍的成年人中的临床效果。
CRD42015027963。
