Comparative efficacy and acceptability of cognitive-behavioural therapy for insomnia and its abbreviated versions: a systematic review and network meta-analysis

作者：Masatsugu Sakata, Shino Kikuchi, Masami Ito, Rie Toyomoto, Hikari Takashina, Shintaro Hara, Ryuichiro Yamamoto, Shun Nakajima, Hiroku Noma, Kota Imai, Shunici Sato, Daiki Nagaoka, Yusuke Takahashi, Keita Kawai, Seina Shinno, Azusa Ishii, Michael L. Perlis, Cagdas Türkmen, Elisabeth Hertenstein, Annemieke van Straten, Yuki Furukawa · 发表于：medRxiv · 年份：2026 · DOI：10.64898/2026.07.04.26357278 · 研究领域：Sleep and related disorders、Sleep and Wakefulness Research、Sleep and Work-Related Fatigue

ABSTRACT Objective To assess the comparative efficacy and acceptability of cognitive behavioural therapy for insomnia (CBT-I), its abbreviated versions and control conditions. Design Systematic review and network meta-analysis. Methods Screening, data extraction, coding, and risk of bias assessment were performed independently and in duplicate. Frequentist, random-effects network meta-analyses estimated odds ratios (ORs) or mean differences with 95% confidence intervals (CIs). The primary outcome was insomnia remission post-treatment. Secondary outcomes included dropout and subjective sleep continuity measures. Quality of the evidence for each arm was graded using the confidence in network meta-analysis (CINeMA). Data sources We searched MEDLINE, Embase, PsycINFO and Cochrane CENTRAL from inception to December 15, 2025, with a medical information specialist. Eligibility criteria for selecting studies Randomized –controlled trials (RCTs) comparing CBT-I and its abbreviated versions with each other or with control conditions, in adults with insomnia, with or without comorbidities. To reduce clinical heterogeneity related to treatment intensity and adherence, we restricted inclusion to in-person delivery. Results We identified 11,379 records and included 77 RCTs (5,731 participants; mean age 52.2 years; 3,473 female). CBT-I (number of arms k = 53; number of participants n = 2,002), sleep restriction and stimulus control therapy (SRT&SCT; k = 16; n = 549), sleep restriction t...