Scholarlink

Purpose <p>To evaluate the effects of acceptance and commitment therapy (ACT) for insomnia compared with waitlist/standard control conditions and cognitive behavioral therapy for insomnia (CBT-I).</p> Methods <p>A systematic review and meta-analysis of randomized controlled trials was conducted. We searched on PubMed, Embase, and the Cochrane Library for studies comparing ACT or ACT-based interventions with non-ACT conditions in patients with insomnia. Continuous outcomes were pooled using a restricted maximum likelihood random-effects model on R.</p> Results <p>ACT showed moderate-to-large improvement in insomnia symptom severity compared with waitlist/standard controls (SMD − 0.67, 95% CI − 1.08 to − 0.25). We observed no significant difference in insomnia severity between ACT and CBT-I at posttreatment (SMD 0.21, 95% CI − 0.02 to 0.43) or at 6-month follow-up (SMD 0.14, 95% CI − 0.15 to 0.42). CBT-I showed significant improvement in remission (ISI &lt; 8 at posttreatment) compared to ACT at posttreatment (RR 0.81; 95% CI 0.67 to 0.98), but not at follow-up (RR 0.78; 95% CI 0.47 to 1.29). Treatment response rates (&gt; 7-point ISI reduction) did also not differ significantly. Compared with waitlist/standard control, ACT produced a small-to-moderate reduction in depression (SMD − 0.34, 95% CI − 0.57 to − 0.12) and anxiety symptoms (SMD − 0.42, 95% CI − 0.67 to − 0.17).</p> Conclusion <p>ACT can be an efficacious treatment for insomnia with particularly strong outcomes for its psychological symptoms. Nevertheless, CBT-I remains the gold standard due to its more extensive and consistent evidence base.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Acceptance and commitment therapy for insomnia: an updated meta-analysis of randomized controlled trials

  • 期刊论文

  • 发表日期：

    2026年8月3日

查看全文
  • Douglas Barroso,
  • Natanael de Paula Portilho,
  • Alicja Garbacka-Struzik,
  • Diogo Carrazzoni Godoi,
  • Maurício Prätzel Ellwanger,
  • Thaís Pereira Mendes,
  • Vitor Expedito Alves Ribeiro,
  • Victor Gonçalves Soares,
  • Larissa C. Hespanhol,
  • Maria Luísa Siegloch,
  • Ibrahim Radi Zahran,
  • Victoria Stadler de Abreu,
  • Helen Michaela de Oliveira,
  • Brandon Peluffo,
  • Eduardo Cerchi,
  • Daniel B. Kay,
  • Renatha El Rafihi-Ferreira

摘要

Purpose

To evaluate the effects of acceptance and commitment therapy (ACT) for insomnia compared with waitlist/standard control conditions and cognitive behavioral therapy for insomnia (CBT-I).

Methods

A systematic review and meta-analysis of randomized controlled trials was conducted. We searched on PubMed, Embase, and the Cochrane Library for studies comparing ACT or ACT-based interventions with non-ACT conditions in patients with insomnia. Continuous outcomes were pooled using a restricted maximum likelihood random-effects model on R.

Results

ACT showed moderate-to-large improvement in insomnia symptom severity compared with waitlist/standard controls (SMD − 0.67, 95% CI − 1.08 to − 0.25). We observed no significant difference in insomnia severity between ACT and CBT-I at posttreatment (SMD 0.21, 95% CI − 0.02 to 0.43) or at 6-month follow-up (SMD 0.14, 95% CI − 0.15 to 0.42). CBT-I showed significant improvement in remission (ISI < 8 at posttreatment) compared to ACT at posttreatment (RR 0.81; 95% CI 0.67 to 0.98), but not at follow-up (RR 0.78; 95% CI 0.47 to 1.29). Treatment response rates (> 7-point ISI reduction) did also not differ significantly. Compared with waitlist/standard control, ACT produced a small-to-moderate reduction in depression (SMD − 0.34, 95% CI − 0.57 to − 0.12) and anxiety symptoms (SMD − 0.42, 95% CI − 0.67 to − 0.17).

Conclusion

ACT can be an efficacious treatment for insomnia with particularly strong outcomes for its psychological symptoms. Nevertheless, CBT-I remains the gold standard due to its more extensive and consistent evidence base.