Self-help cognitive-behavioral therapy for insomnia: A meta-analysis of randomized controlled trials

Fiona Yan Yee Ho, Ka Fai Chung, Wing Fai Yeung, Tommy H. Ng, Ka Shing Kwan, Kam Ping Yung, Sammy K. Cheng

Research output: Journal article publicationReview articleAcademic researchpeer-review

119 Citations (Scopus)

Abstract

Self-help cognitive-behavioral therapy (CBT) is an increasingly popular treatment option for insomnia. The objective of this meta-analysis was to compile an up-to-date evaluation on the efficacy, adherence, acceptability and dropout rate of self-help CBT for insomnia. We systematically searched six key electronic databases up until May 2013. Two researchers independently selected relevant publications, extracted data, and evaluated methodological quality according to the Cochrane criteria. Twenty randomized controlled trials were included; 10 of which were published after the last review up until January 2007. Meta-analysis of self-help CBT vs. waiting-list, routine care or no treatment was performed. Results showed that self-help CBT improved sleep, sleep-related cognitions and anxiety and depressive symptoms. Effect sizes for sleep-diary-derived sleep efficiency, sleep onset latency, and wake after sleep onset at immediate posttreatment were 0.80, 0.66, and 0.55, respectively. The average dropout rate of self-help CBT at immediate posttreatment was 14.5%, which was not significantly different from the 16.7% in therapist-administered CBT. Subgroup analyses supported the added benefit of telephone consultation. In conclusion, self-help CBT is efficacious and acceptable as an entry level of a stepped care model for insomnia. In places where face-to-face treatments are unavailable or too costly, self-help CBT can be considered as a compromise.
Original languageEnglish
Pages (from-to)17-28
Number of pages12
JournalSleep Medicine Reviews
Volume19
DOIs
Publication statusPublished - 1 Jan 2015
Externally publishedYes

Keywords

  • Cognitive-behavioral therapy
  • Insomnia
  • Meta-analysis
  • Psychological treatment
  • Randomized controlled trial
  • Self-help
  • Sleep
  • Systematic review

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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