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Behavioural Treatment Considerations for Insomnia: a Review of Meta-analyses

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Abstract

Purpose of Review

The management of insomnia is shrouded with clinical dilemmas resulting in dissatisfaction both for clinicians and patients. Pharmacotherapy, which forms the more popular part of the armamentarium, is fraught with warnings of various adverse effects, though its effectiveness in treatment is undoubtable. Behavioural therapies, which form the other important part of the treatment options, are considered to be underutilised, despite apparent safety with regard to adverse effects. The current manuscript intends to summarize the effectiveness of various behavioural therapies in the management of insomnia.

Recent Findings

A review was conducted on the various meta-analyses published on the said topic. The total number of studies recruited for this review was 31, most of which were on multicomponent cognitive behavioural therapy for insomnia (CBTi) (N = 26). The studies on CBTi were more diverse in their approach and depicted good evidence base as effective management modality. Multi-component CBTi was also safe in special populations and effective in dealing with cognitive symptoms of insomnia. Individual components of CBTi like mindfulness therapy, sleep hygiene and sleep restriction therapies had relatively modest efficacy.

Summary

CBTi forms a safe and effective behavioural therapy for the management of insomnia. It has a good evidence base and can be a prudent treatment option for insomnia. Further research is required to substantiate the evidence base for other behavioural therapies.

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Authors and Affiliations

  1. Department of Psychiatry, All India Institute of Medical Sciences, Dalmau Road, Munshiganj, Raebareli, 229405, India

    Arghya Pal

  2. Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, India

    Aniruddha Basu

  3. Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, India

    Ravi Gupta

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  1. Arghya Pal
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Correspondence to Arghya Pal.

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AP and AB have no conflict of interest to declare. RG has received grants from Indian Council of Medical Research, National Health Mission, Uttarakhand and Uttarakhand Council for Science and Technology and royalties from Elsevier RELX India, Springer Nature, Singapore and Apple Academic Press, USA, but none pertaining to this manuscript.

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Pal, A., Basu, A. & Gupta, R. Behavioural Treatment Considerations for Insomnia: a Review of Meta-analyses. Curr Sleep Medicine Rep 9, 257–264 (2023). https://doi.org/10.1007/s40675-023-00264-7

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