Cognitive behavioral therapy for insomnia (CBT-I) in patients with fibromyalgia: a systematic review and metaanalysis
Purpose: We aimed to evaluate the effectiveness of CBT-i in patients with fibromyalgia in comparison with other non-pharmacological treatments. Methods: Randomized controlled trials assessing the effects of CBT-i in adults with fibromyalgia, published in English or Spanish, were eligible. Electronic...
| Autores: | , , , , , , , , |
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| Tipo de documento: | artigo |
| Estado: | Versión aceptada para publicación |
| Data de publicação: | 2022 |
| País: | España |
| Recursos: | Universitat de Lleida (UdL) |
| Repositório: | Repositori Obert UdL |
| OAI Identifier: | oai:dnet:.___________::8c2c7bb895726bee3b9cf680bae6a38a |
| Acesso em linha: | https://dx.doi.org/10.1080/09638288.2021.1954706 https://hdl.handle.net/10459.1/469859 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Fibromyalgia Insomnia Sleep Poor sleep quality Cognitive behavioral Therapy for insomnia Systematic review |
| Resumo: | Purpose: We aimed to evaluate the effectiveness of CBT-i in patients with fibromyalgia in comparison with other non-pharmacological treatments. Methods: Randomized controlled trials assessing the effects of CBT-i in adults with fibromyalgia, published in English or Spanish, were eligible. Electronic searches were performed using PubMed, Scopus, The Cochrane Library, WebOfKnowledge and Psicodoc databases in March 2021. The main outcome measures were sleep efficiency and sleep quality. Secondary outcomes included pain, depression, and anxiety. Results: Of 226 studies reviewed, five were included in the meta-analysis. CBT-i compared with non-pharmacological treatments showed no significant improvements in sleep efficiency (p = 0.05; standardized mean difference (SMD) [95% CI] 0.31 [-0.00 to 0.61]). CBT-i showed significant improvements in sleep quality (p = 0.009; SMD [95% CI] - 0.53 [-0.93 to -0.13]), pain (p = 0.002; SMD [95% CI] - 0.41 [-0.67 to -0.16]), anxiety (p = 0.001; SMD [95% CI] - 0.46 [-0.74 to 0.18]) and depression (p = 0.02; SMD [95% CI] - 0.33 [-0.61 to -0.05]), compared to non-pharmacological treatments. Effect sizes ranged from small to moderate. Conclusions: CBT-i was associated with a significant improvement in sleep quality, pain, anxiety, and depression, although these results are retrieved from very few studies with only very low to low quality evidence. Trial registration: The review protocol was registered with PROSPERO (Record ID ¼ CRD42016030161). |
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