Comparative efficacy of interventions for insomnia in cancer patients: a systematic review and network meta-analysis
Author: Xuehong Sun1, Yushu Zhang1, Zhi Lu1, Zhilong Shu1, Kui Zhang2, Yijiu Chen3
Affiliation:
1 Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
2 Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China. cheungque@163.com.
3 Department of Forensic Pathology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China. newman-zhk@163.com.
Conference/Journal: Sleep Breath
Date published: 2025 Mar 18
Other:
Volume ID: 29 , Issue ID: 2 , Pages: 133 , Special Notes: doi: 10.1007/s11325-025-03300-8. , Word Count: 216
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.
Keywords: CBT-I; Electroacupuncture; Insomnia; Network meta-analysis; Tai Chi.
PMID: 40100466 DOI: 10.1007/s11325-025-03300-8
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