Umbrella Review and Meta-Analysis: The Efficacy of Nonpharmacological Interventions for Sleep Disturbances in Children and Adolescents

作者：Samantha Hornsey, Corentin J. Gosling, Lucie Jurek, Mikaïl Nourredine, Laurence Telesia, Marco Solmi, Isabel Butt, Kate Greenwell, Ingrid Müller, Catherine M. Hill, Samuele Cortese, Catherine M. Hill, Samuele Cortese, Andrea Bilbow, Andrew Cook, David Daley, Hazel Everitt, Joanne Lord, Ingrid Muller, Katya Rubia, Paramala Janardhanan Santosh, Debra Skene, Aditya Sharma, Emily Simonoff · 发表于：Journal of the American Academy of Child & Adolescent Psychiatry · 年份：2024 · DOI：10.1016/j.jaac.2024.10.015 · 被引用次数：27 · 研究领域：Sleep and related disorders、Sleep and Wakefulness Research、Sleep and Work-Related Fatigue

OBJECTIVE: We conducted an umbrella review of systematic reviews (SRs), with or without meta-analysis (MA), of randomized controlled trials (RCTs) assessing nonpharmacological sleep interventions for children and adolescents across various clinical populations. METHOD: We searched multiple electronic databases up to January 24, 2024. Meta-analyzable data from RCTs in the retrieved SRs/MAs were pooled using Metaumbrella. Primary outcomes were subjective/objective child sleep parameters. Additional outcomes included child health/functioning and parental sleep/health. The quality of the MAs/SRs was assessed with Assessment of Multiple Systematic Reviews (AMSTAR-2), and the certainty of evidence using Grading of Recommendations, Assessment, Development and Evaluations (GRADE). RESULTS: We included 93 SRs/MAs covering 393 RCTs, with 25 (17%, 39%, and 30%: high, moderate, and low quality) providing data for quantitative synthesis. Behavioral interventions, usually multicomponent including parent training, psychoeducation, and/or specific sleep therapy/strategies, showed beneficial effects on night waking, sleep duration, overall sleep disturbance, mood/depression, and maternal sleep quality (standardized mean difference [SMD] = 0.10-0.80) in participants with sleep problems without a formal sleep disorder diagnosis. For those with a formal diagnosis (mainly insomnia), benefits were found for night waking, sleep efficiency (subjective/actigraphically measured), and sleep onset laten...