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Effectiveness of nonpharmacological interventions for menopause-related insomnia: A systematic review and Bayesian
Zhongli Wang1, Haoyu Yang2, Shutong Li1
1Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
Background:
Nonpharmacological therapies are widely used to improve the sleep quality of menopausal women experiencing insomnia. It is necessary to clarify which of the nonpharmacological therapies studied in randomized controlled trials are most effective and comprehensively evaluate their impacts.
Method:
We conducted a systematic search across PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the Web of Science from their inception until May 25, 2025. To analyze and visualize our results, we utilized the "BUGSnet" and "JAGS" packages within the R statistical software. Employing a random-effects model, we calculated effect sizes as mean differences (MD) for continuous outcomes. Furthermore, we performed a quality assessment of our study using the RoB2 tool.
Results:
Out of 1925 studies screened, 44 were included in the final analysis. The findings revealed that, compared with a control condition, relaxation, cognitive behavioral therapy, mindfulness, aromatherapy, acupuncture, massage, yoga and exercise all significantly improved sleep quality. The MD values ranged from -5.61 (95 % CrI: -8.70 to -2.50) for mindfulness to -2.40 (95 % CrI: -4.19 to -0.62) for exercise. Mindfulness was also the most effective based on SUCRA.
Conclusion:
Relaxation, cognitive behavioral therapy, mindfulness, aromatherapy, acupuncture, massage, yoga and exercise all significantly improve sleep quality and mindfulness is the most effective.
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