Which Non-pharmacological Sleep Interventions Are Most Effective After Cardiac Surgery?: A Network Meta-Analysis

Area of Science:

• Cardiology
• Sleep Medicine
• Psychology

Background:

• Sleep disturbances are a frequent complication following cardiac surgery.
• Nonpharmacological interventions like CBT and relaxation show promise but their comparative effectiveness is unknown.

Purpose of the Study:

• To compare multiple nonpharmacological interventions for improving sleep quality in post-cardiac surgery patients using network meta-analysis (NMA).
• To identify the most effective intervention for enhancing sleep in this population.

Main Methods:

• A systematic literature search adhering to PRISMA-NMA guidelines was conducted across six databases in February 2025.
• Included randomized controlled trials (RCTs) measuring sleep quality via the Pittsburgh Sleep Quality Index.
• Network meta-analysis was performed using STATA to rank interventions.

Main Results:

• Nineteen studies with 1944 participants were analyzed, evaluating interventions including CBT, relaxation, and aromatherapy.
• Nonpharmacological interventions significantly improved sleep quality post-cardiac surgery (SMD 1.02).
• Cognitive Behavioral Therapy (CBT) demonstrated the highest efficacy (SUCRA 88.5%).

Conclusions:

• Cognitive Behavioral Therapy (CBT) is clinically valuable for managing postsurgical sleep disturbances.
• Standardized guidelines for CBT implementation in cardiac surgery recovery are recommended.
• Further research should explore diverse CBT models and interventions across different surgical types.