Sun Xuehong, Zhang Yushu, Lu Zhi, Shu Zhilong, Zhang Kui, Chen Yijiu
Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
Sleep Breath. 2025 Mar 18;29(2):133. doi: 10.1007/s11325-025-03300-8.
Cancer-related insomnia demonstrates twice the prevalence observed in the general population, with significant implications for disease progression. This network meta-analysis systematically compares the therapeutic efficacy of diverse interventions for managing insomnia in oncological populations.
We systematically queried four biomedical databases (PubMed, Embase, Medbase, and Web of Science) for eligible studies assessing insomnia interventions in cancer patients. Primary outcomes encompassed standardized metrics: Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE). A frequentist approach with random-effects model was employed for comparative effectiveness analysis.
The analysis incorporated 21 studies with sample sizes ranging from 16 to 255 participants. Comparative evaluation against standard care revealed that both cognitive behavioral therapy for insomnia (CBT-I) (MD = - 3.04, 95%CI[- 4.49,-1.59]) and electroacupuncture (MD = - 3.80, 95%CI[- 6.50,-1.09]) produced clinically meaningful reductions in ISI scores, while CBT-I (MD = 2.71%, 95%CI[0.89,4.53]) and Tai Chi (MD = 5.26%, 95%CI[0.41,10.11]) exhibited statistically significant improvements in sleep efficiency metrics.
CBT-I emerges as an evidence-based intervention for ameliorating insomnia severity and optimizing sleep efficiency in cancer patients. Complementary modalities including electroacupuncture and Tai Chi present viable alternatives. Methodological limitations necessitate future rigorously designed trials to strengthen clinical recommendations.
癌症相关失眠的患病率是普通人群的两倍，对疾病进展有重大影响。这项网络荟萃分析系统地比较了多种干预措施对肿瘤患者失眠的治疗效果。
我们系统地检索了四个生物医学数据库（PubMed、Embase、Medbase和Web of Science），以查找评估癌症患者失眠干预措施的合格研究。主要结局包括标准化指标：失眠严重程度指数（ISI）、匹兹堡睡眠质量指数（PSQI）、入睡潜伏期（SOL）、睡眠中觉醒时间（WASO）、总睡眠时间（TST）和睡眠效率（SE）。采用随机效应模型的频率学派方法进行比较有效性分析。
该分析纳入了21项研究，样本量从16名到255名参与者不等。与标准护理的比较评估显示，失眠认知行为疗法（CBT-I）（MD = - 3.04，95%CI[- 4.49，-1.59]）和电针疗法（MD = - 3.80，95%CI[- 6.50，-1.09]）均使ISI评分在临床上有意义地降低，而CBT-I（MD = 2.71%，95%CI[0.89，4.53]）和太极拳（MD = 5.26%，95%CI[0.41，10.11]）在睡眠效率指标上有统计学显著改善。
CBT-I是改善癌症患者失眠严重程度和优化睡眠效率的循证干预措施。包括电针疗法和太极拳在内的辅助疗法是可行的替代方案。方法学上的局限性需要未来进行严格设计的试验以加强临床建议。
