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针对癌症患者睡眠障碍的身心疗法:系统评价和荟萃分析。

Mind-body therapies for sleep disturbance among patients with cancer: A systematic review and meta-analysis.

机构信息

School of Nursing, Xuzhou Medical University, Xuzhou, China.

School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.

出版信息

Complement Ther Med. 2023 Aug;75:102954. doi: 10.1016/j.ctim.2023.102954. Epub 2023 May 25.

Abstract

OBJECTIVES

To assess whether mind-body therapies (MBTs) are effective for relieving sleep disturbance among patients with cancer.

DESIGN

Systematic review and meta-analysis of randomized controlled trials (RCTs).

METHODS

Seven English electronic databases were searched from the date of inception to September 2022. All RCTs that included adults (≥18 years) who were treated with mindfulness, yoga, qigong, relaxation, and hypnosis were screened. The outcome was subjective and/or objective sleep disturbance.The revised Cochrane tool (RoB 2.0) was applied to evaluate the risk of bias. The RevMan software was applied to assessed each outcome according different control groups and assessment time points. Subgroup analyses were performed according to different categories of MBTs.

RESULTS

Sixty-eight RCTs (6339 participants) were identified. After requesting for missing data from corresponding authors of included RCTs, 56 studies (5051 participants) were included in the meta-analysis. The meta-analysis showed a significant immediate effect of mindfulness, yoga, relaxation, and hypnosis on subjective sleep disturbance, compared with usual care or wait list control, and the effect of mindfulness lasted at least 6 months. For objective sleep outcomes, we observed significant immediate effects of yoga on wake after sleep onset and of mindfulness on sleep onset latency and total sleep time. Compared with active control interventions, MBTs had no significant effect on sleep disturbance.

CONCLUSIONS

Mindfulness, yoga, relaxation, and hypnosis were effective in sleep disturbance severity reduction among patients with cancer at post-intervention, and the effect of mindfulness lasted at least 6 months. Future MBTs studies should apply both objective and subjective sleep measurement tools.

摘要

目的

评估身心疗法(MBTs)是否可有效缓解癌症患者的睡眠障碍。

设计

系统评价和随机对照试验(RCT)的荟萃分析。

方法

从成立之初到 2022 年 9 月,检索了 7 个英文电子数据库。筛选了纳入正念、瑜伽、气功、放松和催眠治疗成年人(≥18 岁)的 RCT。主要结局为主观和/或客观睡眠障碍。采用修订后的 Cochrane 工具(RoB 2.0)评估偏倚风险。RevMan 软件用于根据不同的对照组和评估时间点评估每个结局。根据 MBTs 的不同类别进行亚组分析。

结果

共确定了 68 项 RCT(6339 名参与者)。在向纳入 RCT 的相应作者请求缺失数据后,有 56 项研究(5051 名参与者)纳入荟萃分析。荟萃分析显示,与常规护理或等待名单对照相比,正念、瑜伽、放松和催眠对主观睡眠障碍具有显著的即时效应,正念的效应至少持续 6 个月。对于客观睡眠结局,我们观察到瑜伽对睡眠后觉醒和正念对入睡潜伏期和总睡眠时间的即时影响显著。与积极对照干预相比,MBTs 对睡眠障碍没有显著影响。

结论

正念、瑜伽、放松和催眠在癌症患者中可有效减轻睡眠障碍的严重程度,且正念的效应至少持续 6 个月。未来的 MBTs 研究应同时使用客观和主观的睡眠测量工具。

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