Abstract
Background and purpose:
Sleep disturbance is a common problem affecting over 70%
of people with chronic musculoskeletal pain (CMP). Although prior pairwise meta-analyses have summarized the efficacy of non-pharmacological interventions for alleviating sleep disturbance in people with chronic pain, no network meta-analysis (NMA) has investigated the comparative efficacy of various non-pharmacological interventions.
Our study aimed to conduct a systematic review and NMA
to summarize the relevant evidence in people with CMP.
Methods:
Relevant publications were searched systematically from
seven electronic databases from their inception to February 2023. Two independent reviewers conducted study
selection and data extraction. A random-effects NMA in
a frequentist framework was performed to synthesize the
treatment efficacy (change in sleep quality) and acceptability (discontinuations). This study was registered with
PROSPERO (CRD42023395007).
Results:
A total of 15,641 records were identified from databases and
references of previous studies, of which 107 randomized
controlled trials with 8,121 participants were included in the
NMA. The surface under the cumulative ranking curve indicated that cognitive behavioral therapy (CBT) was ranked
the best among 14 non-pharmacological interventions for
improving sleep quality in people with CMP. There was no
significant difference in the treatment acceptability among
different interventions and true control.
Conclusion:
CBT is the most effective non-pharmacological intervention for improving sleep quality in people with CMP. These
findings could inform clinicians and people with CMP on
choosing optimal non-pharmacological interventions for
sleep improvement. Considering the limitations in current
evidence, more well-designed studies targeting sleep improvement are warranted to further validate the conclusion
of this NMA.
Sleep disturbance is a common problem affecting over 70%
of people with chronic musculoskeletal pain (CMP). Although prior pairwise meta-analyses have summarized the efficacy of non-pharmacological interventions for alleviating sleep disturbance in people with chronic pain, no network meta-analysis (NMA) has investigated the comparative efficacy of various non-pharmacological interventions.
Our study aimed to conduct a systematic review and NMA
to summarize the relevant evidence in people with CMP.
Methods:
Relevant publications were searched systematically from
seven electronic databases from their inception to February 2023. Two independent reviewers conducted study
selection and data extraction. A random-effects NMA in
a frequentist framework was performed to synthesize the
treatment efficacy (change in sleep quality) and acceptability (discontinuations). This study was registered with
PROSPERO (CRD42023395007).
Results:
A total of 15,641 records were identified from databases and
references of previous studies, of which 107 randomized
controlled trials with 8,121 participants were included in the
NMA. The surface under the cumulative ranking curve indicated that cognitive behavioral therapy (CBT) was ranked
the best among 14 non-pharmacological interventions for
improving sleep quality in people with CMP. There was no
significant difference in the treatment acceptability among
different interventions and true control.
Conclusion:
CBT is the most effective non-pharmacological intervention for improving sleep quality in people with CMP. These
findings could inform clinicians and people with CMP on
choosing optimal non-pharmacological interventions for
sleep improvement. Considering the limitations in current
evidence, more well-designed studies targeting sleep improvement are warranted to further validate the conclusion
of this NMA.
Original language | English |
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Pages | 8 |
Number of pages | 1 |
Publication status | Published - 24 Jun 2023 |
Event | Hong Kong Physiotherapy Association 60th Anniversary Conference - Tsuen Wan, Hong Kong, Hong Kong Duration: 24 Jun 2023 → 24 Jun 2023 |
Competition
Competition | Hong Kong Physiotherapy Association 60th Anniversary Conference |
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Country/Territory | Hong Kong |
City | Hong Kong |
Period | 24/06/23 → 24/06/23 |
Keywords
- Sleep
- musculoskeletal pain
- Network meta-analysis