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Published on: February 17, 2023
Acceptance and commitment therapy for insomnia: an updated meta-analysis of randomized controlled trials
Douglas Barroso1, Natanael de Paula Portilho2, Alicja Garbacka-Struzik3
1Division of Medicine, State University of Santa Cruz, Ilhéus, Brazil. douglascarneirob@gmail.com.
Summary
Acceptance and Commitment Therapy (ACT) shows significant improvement in insomnia symptom severity compared to standard care. While effective for psychological symptoms, it is not superior to Cognitive Behavioral Therapy for Insomnia (CBT-I).
Area of Science:
- Psychiatry
- Psychology
- Behavioral Science
Background:
- Insomnia is a prevalent sleep disorder affecting millions worldwide.
- Cognitive Behavioral Therapy for Insomnia (CBT-I) is the established first-line treatment.
- Acceptance and Commitment Therapy (ACT) is a mindfulness-based behavioral intervention gaining attention for various psychological conditions.
Purpose of the Study:
- To evaluate the efficacy of ACT for insomnia.
- To compare ACT with waitlist/standard controls.
- To compare ACT with CBT-I.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Searched PubMed, Embase, and Cochrane Library.
- Pooled continuous outcomes using a restricted maximum likelihood random-effects model.
Main Results:
- ACT demonstrated moderate-to-large improvement in insomnia symptom severity versus waitlist/standard controls (SMD -0.67).
- No significant difference in insomnia severity was found between ACT and CBT-I posttreatment or at 6-month follow-up.
- ACT showed small-to-moderate reductions in depression (SMD -0.34) and anxiety (SMD -0.42) symptoms compared to controls.
Conclusions:
- ACT is an efficacious insomnia treatment, particularly for psychological symptoms.
- CBT-I remains the gold standard due to a more extensive evidence base.
- ACT offers a viable alternative or adjunct for insomnia management.
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