Comparative efficacy of interventions for insomnia in cancer patients: a systematic review and network meta-analysis.

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Sleep and Breathing Pub Date : 2025-03-18 DOI:10.1007/s11325-025-03300-8

Xuehong Sun, Yushu Zhang, Zhi Lu, Zhilong Shu, Kui Zhang, Yijiu Chen

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引用次数: 0

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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干预措施对癌症患者失眠的比较疗效：系统回顾和网络荟萃分析。

背景：癌症相关性失眠的患病率是普通人群的两倍，对疾病进展有重要影响。本网络荟萃分析系统地比较了不同干预措施对治疗肿瘤人群失眠的疗效。方法：我们系统地查询了四个生物医学数据库（PubMed、Embase、Medbase和Web of Science），以获得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：失眠严重指数（ISI）、匹兹堡睡眠质量指数（PSQI）、睡眠发作潜伏期（SOL）、睡眠发作后醒来（WASO）、总睡眠时间（TST）和睡眠效率（SE）。采用随机效应模型的频率分析方法进行比较效果分析。结果：该分析纳入了21项研究，样本量从16到255名参与者不等。与标准治疗的比较评估显示，失眠的认知行为疗法（CBT-I）（MD = - 3.04, 95%CI[- 4.49,-1.59]）和电针（MD = - 3.80, 95%CI[- 6.50,-1.09]）在ISI评分上均有临床意义的降低，而CBT-I （MD = 2.71%, 95%CI[0.89,4.53]）和太极（MD = 5.26%, 95%CI[0.41,10.11]）在睡眠效率指标上有统计学意义的改善。结论：CBT-I是一种基于证据的干预措施，可改善癌症患者的失眠严重程度和优化睡眠效率。包括电针和太极在内的补充方式是可行的选择。方法学上的局限性需要未来严格设计的试验来加强临床推荐。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep and Breathing 医学-呼吸系统

CiteScore

5.20

自引率

4.00%

发文量

222

审稿时长

3-8 weeks

期刊介绍： The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.