Effect of minimal cognitive behavioral therapy for patients with acute insomnia: A systematic review and meta-analysis

Abstract

Objectives: The current literature lacks a clear evaluation of the effectiveness of Cognitive Behavioral Therapy for Insomnia (CBT-I) on acute insomnia. Our study aims to address this issue through a systematic review and meta-analysis of Randomized Controlled Trials (RCTs).

Method: We systematically searched PubMed, Embase, and Cochrane Library in April 2024 for RCTs comparing patients with clinically significant insomnia symptoms for less than 6 months (ie, acute insomnia) assigned to 1-6 weeks of CBT-I versus no CBT-I.

Results: We included four RCTs comprising 327 patients with acute insomnia, of whom 162 (49.5 %) were randomized to CBT-I. CBT-I significantly reduced the Insomnia Severity Index score (MD -5.28; 95 % CI -6.01, -4.56; p < 0.00001; I² = 18 %), the incidence of chronic insomnia (MD 0.50; 95 % CI 0.35, 0.70; p < 0.0001; I² = 0 %), and the sleep latency (MD -11.04; 95 % CI -18.46, -3.61; p = 0.004; I² = 0 %).

Conclusion: These findings provide preliminary evidence that minimal CBT-I may be a feasible and effective preventive measure against chronic insomnia. However, future RCTs and effectiveness trials are necessary to validate, with greater statistical power, the hypothesis that CBT-I can prevent transition from acute to chronic insomnia, given the limited number of studies in our meta-analysis.

Keywords: Psychotherapy; Short-term insomnia; Sleep impairment; Transient insomnia.