Does cognitive behaviour therapy for insomnia reduce repetitive negative thinking and sleep-related worry beliefs? A systematic review and meta-analysis

Ballesio, Andrea; Bacaro, Valeria; Vacca, Mariacarolina; Chirico, Andrea; Lucidi, Fabio; Riemann, Dieter; Baglioni, Chiara; Lombardo, Caterina

doi:10.1016/j.smrv.2020.101378

Cited by 39 publications

(18 citation statements)

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“…Evidence suggests that CBT for insomnia may reduce anxiety (Belleville et al, 2011), perhaps through reducing anxious worrying (Ballesio et al, 2021). Studies have also examined the integration of CBT for insomnia with techniques specifically targeting anxious worrying (Ballesio et al, 2021). As this is research including only adult samples, further studies need to examine if CBT for insomnia have effect on anxious worrying also in adolescent samples.…”

Section: Resultsmentioning

confidence: 99%

Sleep Duration and Insomnia in Adolescents Seeking Treatment for Anxiety in Primary Health Care

et al. 2021

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There is limited knowledge about sleep in adolescents with elevated levels of anxiety treated within primary health care settings, potentially resulting in sleep problems not being sufficiently addressed by primary health care workers. In the current study self-reported anxiety, insomnia, sleep onset latency, sleep duration, and depressive symptoms were assessed in 313 adolescents (12–16 years; mean age 14.0, SD = 0.84, 84.0% girls) referred to treatment for anxiety within primary health care. Results showed that 38.1% of the adolescents met criteria for insomnia, 34.8% reported short sleep duration (<7 h), and 83.1% reported long sleep onset latency (≥30 min). Total anxiety symptoms were related to all sleep variables after controlling for age and sex. Furthermore, all anxiety symptom sub-types were associated with insomnia and sleep onset latency, whereas most anxiety subtypes were associated with sleep duration. Adolescents’ depressive symptoms accounted for most of the anxiety-sleep associations, emphasizing the importance of depressive symptoms for sleep. However, anxiety was associated with insomnia and sleep onset latency also among youth with low levels of depressive symptoms. The findings suggests that primary health care workers should assess sleep duration, sleep onset latency, and insomnia in help-seeking adolescents with anxiety.

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Section: Resultsmentioning

confidence: 99%

Sleep Duration and Insomnia in Adolescents Seeking Treatment for Anxiety in Primary Health Care

et al. 2021

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“…Insomnia is a general sleep disorder in modern society, which has been considered to be a common risk factor for psychological and physical diseases. [ 1 ] The prevalence of insomnia in the general population is 10% to 15%. [ 2 ] In recent years, due to the acceleration of people's pace of life, the incidence rate of insomnia has increased year by year.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of Shumian capsules in treating insomnia

et al. 2021

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Background: It is known to all that the incidence of insomnia is becoming higher and higher with the increase of people's life stress. To some extent, it has brought about bad effects on people's life, work, study, and health, such as mental exhaustion, low work efficiency, and mood irritability. Now there are medications and non-medications methods for insomnia. As one of the treatments for insomnia, western medicine is to prolong the sleeping time and improve the anxious mood. However, taking western medicine to treat insomnia can also be accompanied by some adverse reactions at the same time, such as drug dependence, an allergic reaction, and so on. Traditional Chinese medicine therapy is based on syndrome differentiation and holistic concept. Shumian capsules (SM) are a kind of proprietary Chinese medicine for insomnia, which have the effect of relieving depression and calming the mind. But there are no studies on the efficacy and safety of SM in the treatment of insomnia. Therefore, I will provide a systematic review and meta-analysis to evaluate the efficacy and safety of SM for insomnia. Methods: All the studies searched were from PubMed, EMBASE, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, and WanFang databases, and the studies types included in the analysis were all randomized controlled trials. All the retrieval contents were completed independently by 2 researchers, and a third reviewer would be involved when there existed any disagreement. The eligible studies were screened out according to the inclusion criteria and exclusion criteria, and some useful information was extracted and made into a feature table, including the year of the included studies, the age, and disease course of the participants in the studies and intervention methods, etc. Cochrane risk-of-bias tool was used to evaluate the quality of literature and meta-analysis was conducted by RevMan 5.4 software. Results: A total of 9 articles including 709 participants were included in the study after screening out. The primary outcomes of statistical analysis were cure rate and total effective rate, while the secondary outcomes included Pittsburgh sleep quality index score and incidence of adverse reactions. The results showed that Pittsburgh sleep quality index score of the SM group and Western medicine group were statistically significant (MD = –0.50, 95% confidence interval [CI] = [–0.78, –0.22], P = .0005). The total effective rate of the SM group was slightly higher than that of the Western medicine group, but there was no statistical significance (relative risk [RR] = 1.03, 95% CI = [0.95,1.13], P = .43). Conclusion: This meta-analysis provides evidence for the efficacy and safety of SM in the treatment of insomnia, and provides a new idea for the clinical treatment of insomnia. But more research is needed to support further evi...

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“…CBT‐I is considered the treatment of choice for insomnia, involving psychoeducation to address dysfunctional beliefs about, and behaviours related to, sleep, and training in techniques for reducing bedtime cognitive and physical arousal. Importantly, RNT has been proposed as an important process variable that may predict response to CBT‐I treatment (Ballesio et al., 2021). Meta‐analyses suggest that CBT‐I is effective for reducing night‐time and daytime symptoms of insomnia (Benz et al., 2020; van der Zweerde et al., 2019) and, of relevance to the population sampled in this study, CBT‐I treatment response in college students has been shown to be similar to that of the general population (D. J. Taylor et al., 2014).…”

Section: Discussionmentioning

confidence: 99%

Bedtime repetitive negative thinking moderates the relationship between psychological stress and insomnia

Benham

2021

Stress and Health

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Research suggests that psychological stress is associated with insomnia, but there is limited research on vulnerabilities that might amplify this association, particularly in college students. Based on a sample of 507 undergraduates, the current study demonstrates that the observed positive correlation between self‐perceived stress and insomnia severity is moderated by the tendency to engage in repetitive negative thinking (RNT) at bedtime. Additionally, separate analyses of those who scored below/above the threshold for insomnia (non‐insomniacs vs. insomniacs) revealed that the interaction between stress and these negative bedtime cognitions differed qualitatively between the two groups. In insomniacs, the stress‐insomnia relationship was dampened for those with lower levels of bedtime RNT, but amplified for those with higher levels. For non‐insomniacs, the stress‐insomnia relationship was stronger for those with minimal bedtime RNT, while higher levels of bedtime RNT appeared to overshadow this association. To develop a better understanding of the contribution of stress and RNT to clinically relevant levels of insomnia, future studies should take into account the dissimilar patterns of moderation seen in non‐insomniacs and insomniacs, either through prospective screening or separate analyses. Findings from the current study suggest that insomnia treatments that can simultaneously reduce stress and address bedtime RNT may be optimal.

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Does cognitive behaviour therapy for insomnia reduce repetitive negative thinking and sleep-related worry beliefs? A systematic review and meta-analysis

Cited by 39 publications

References 91 publications

Sleep Duration and Insomnia in Adolescents Seeking Treatment for Anxiety in Primary Health Care

Sleep Duration and Insomnia in Adolescents Seeking Treatment for Anxiety in Primary Health Care

Efficacy and safety of Shumian capsules in treating insomnia

Bedtime repetitive negative thinking moderates the relationship between psychological stress and insomnia

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