Cognitive and behavioural therapy for insomnia in the treatment of adolescent insomnia: A systematic review and meta-analysis of randomised controlled trials.

Abstract

Insomnia is common in adolescents with associated negative health consequences. This systematic review and meta-analysis assessed the effect of cognitive behavioural therapy for insomnia interventions on insomnia symptoms and subjective sleep quality in adolescents aged 10-19 years. Key electronic databases, including CINAHL, Embase, MEDLINE, PsycINFO and Scopus, were systematically searched from inception to October 2024, and five randomised controlled trials met inclusion criteria for qualitative synthesis. Four randomised controlled trials, examining a total of 527 participants, were included in the meta-analysis. One randomised controlled trial employing a hybrid cluster design was excluded in quantitative analyses due to the number of clusters and sizes not reported. Cognitive behavioural therapy for insomnia delivered to adolescents with insomnia improved subjective sleep quality and insomnia symptoms, with effect sizes (Hedge's g) of 0.4 and 1.04, respectively. Our findings provide support for the efficacy of cognitive behavioural therapy for insomnia in the treatment of adolescents with insomnia regardless of delivery modality. Further high-quality randomised controlled trials are required to strengthen our findings and understand how best to deliver cognitive behavioural therapy for insomnia to adolescents.