Cognitive behavioral therapy for insomnia (CBT-i) in patients with fibromyalgia: a systematic review and meta-analysis

Climent‐Sanz, Carolina; Valenzuela‐Pascual, Fran; Martínez-Navarro, Oriol; Blanco-Blanco, Joan; Rubí-Carnacea, Francesc; García-Martínez, Ester; Soler-González, Jorge; Barallat-Gimeno, Eva; Gea-Sánchez, Montserrat

doi:10.1080/09638288.2021.1954706

Cited by 25 publications

(15 citation statements)

References 70 publications

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“…This meta-analysis supports the efficacy of dCBT-I on insomnia and subclinical symptoms of depression and anxiety symptoms. The current study demonstrated small-to-moderate effect sizes, which was consistent with prior meta-analyses conducted to evaluate the effectiveness of cognitive behavior therapies for depression, anxiety, and sleep disorders 38 . Studies have identified mostly small to moderate effect when having treatment as usual or pill placebo as the control condition 39 .…”

Section: Discussionsupporting

confidence: 85%

Digital cognitive behavioral therapy for insomnia on depression and anxiety: a systematic review and meta-analysis

Lee

Park

et al. 2023

npj Digit. Med.

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Despite research into the development of digital cognitive behavioral therapy for insomnia (dCBT-I), research into the outcomes of dCBT-I on insomnia and the associated clinical conditions of depression and anxiety have been limited. The PubMed, PsycINFO (Ovid), Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) on adult patients with insomnia also having reported measures of depressive or anxiety symptoms. In total, 2504 articles were identified after duplicate removal, and 22 RCTs were included in the final meta-analysis. At the post-treatment assessment, the dCBT-I group had a small to moderate effect in alleviating depressive (standardized mean difference (SMD) = −0.42; 95% CI: −0.56, −0.28; p < 0.001; k = 21) and anxiety symptoms (SMD = −0.29; 95% CI: −0.40, −0.19; p < 0.001; k = 18), but had a large effect on sleep outcome measures (SMD = −0.76; 95% CI: −0.95, −0.57; p < 0.001; k = 22). When considering treatment adherence, the treatment effects of those in the high adherent groups identified a more robust outcome, showing greater effect sizes than those in the low adherent groups for depression, anxiety, and sleep outcomes. Furthermore, additional subgroup analysis on studies that have used the fully automated dCBT-I treatment without the support of human therapists reported significant treatment effects for depression, anxiety, and sleep outcomes. The results demonstrated that digital intervention for insomnia yielded significant effects on alleviating depressive and anxiety symptoms as well as insomnia symptoms. Specifically, the study demonstrated significant effects on the above symptoms when considering treatment adherence and implementing fully automated dCBT-I.

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Section: Discussionsupporting

confidence: 85%

Digital cognitive behavioral therapy for insomnia on depression and anxiety: a systematic review and meta-analysis

Lee

Park

et al. 2023

npj Digit. Med.

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“…(36) Condition specific reviews including patients with lower back pain, fibromyalgia, and osteoarthritis show similar results with CBT therapies improving short-term sleep outcomes. (36)(37)(38)(39) CBT may be particularly suitable for people with chronic pain because such approaches can address pain and sleep in tandem. Some individuals who live with chronic pain may engage in "pain catastrophizing."…”

Section: Intervention Approachesmentioning

confidence: 99%

“…( 36 ) Condition specific reviews including patients with lower back pain, fibromyalgia, and osteoarthritis show similar results with CBT therapies improving short‐term sleep outcomes. ( 36 , 37 , 38 , 39 )…”

Section: Intervention Approachesmentioning

confidence: 99%

The Importance of Sleep for People With Chronic Pain: Current Insights and Evidence

Whale

Gooberman‐Hill

2022

JBMR Plus

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We are currently in the midst of a sleep crisis. Our current work and lifestyle environments are normalizing poor sleep with substantial negative impact on our health. Research on sleep has linked sleep deprivation to poorer mental health, obesity, cancer, diabetes, heart disease, and a myriad of other health conditions. Sleep deprivation is an even greater issues for people with musculoskeletal conditions and chronic pain. Between 67% and 88% of individuals with chronic pain experience sleep disruption and insomnia, and at least 50% of people with insomnia report chronic pain. The link between sleep and pain is well documented. Experimental, cohort, and longitudinal studies have all demonstrated that restricted sleep is linked to greater pain. Poor sleep therefore not only affects general health but has a direct impact on inflammation, pain response, and experience. Improving sleep in people living with musculoskeletal conditions and with chronic pain has the potential to deliver great benefit to many. This article describes the evidence base that can underpin such work, including research about the link between pain and sleep as well as theories and approaches to intervention that may help.

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“…Fibromyalgia treatment includes non pharmacological, 5 , 6 , 7 , 8 , 9 pharmacological, or combined strategies. Non pharmacological treatment includes education, 10 cognitive therapies, 11 , 12 , 13 , 14 , 15 and passive versus active physical therapies. 16 , 17 , 18 , 19 , 20 Passive treatment modalities may include massages, acupuncture, 21 and additional alternative medicine treatments, 8 , 13 , 22 , 23 , 24 while active physical therapies include physiotherapy, hydrotherapy, yoga, Pilates, and aerobic activities.…”

Section: Introductionmentioning

confidence: 99%

The role of cannabis in treatment‐resistant fibromyalgia women

et al. 2022

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Fibromyalgia is a pain-focused syndrome involving diffuse chronic myalgia, somatization, sleep disturbances, and cognitive and functional impairments affecting approximately 3% of the general population, mostly following trauma, motor vehicle accidents, acute febrile disease, or mental illness stress. 1 Women are affected two times more than men. 2 Although extensively investigated, anatomic or pathophysiological causes for fibromyalgia are still obscure. [2][3][4] Fibromyalgia treatment includes non pharmacological, 5-9 pharmacological, or combined strategies. Non pharmacological treatment includes education, 10 cognitive therapies, [11][12][13][14][15] and passive versus active physical therapies. [16][17][18][19][20] Passive treatment modalities may include massages, acupuncture, 21 and additional alternative medicine treatments, 8,13,[22][23][24] while active physical therapies

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Cognitive behavioral therapy for insomnia (CBT-i) in patients with fibromyalgia: a systematic review and meta-analysis

Cited by 25 publications

References 70 publications

Digital cognitive behavioral therapy for insomnia on depression and anxiety: a systematic review and meta-analysis

Digital cognitive behavioral therapy for insomnia on depression and anxiety: a systematic review and meta-analysis

The Importance of Sleep for People With Chronic Pain: Current Insights and Evidence

The role of cannabis in treatment‐resistant fibromyalgia women

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