Cognitive behavioral therapy for insomnia across the spectrum of alcohol use disorder: a systematic review and meta-analysis
Insomnia is prevalent among patients with alcohol use disorder (AUD), potentially undermining treatment and increasing the risk of relapse. Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for insomnia, but its efficacy is not well-characterized in patients a...
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| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
April 2025
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| In: |
Sleep medicine reviews
Year: 2025, Volume: 80, Pages: 110 |
| ISSN: | 15322955 |
| DOI: | 10.1016/j.smrv.2025.102049 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.smrv.2025.102049 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1087079225000024 
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| Author Notes: | Cagdas Türkmen, Carlotta L. Schneider, Wolfgang Viechtbauer, Ingeborg Bolstad, Subhajit Chakravorty, Mary Beth Miller, Håvard Kallestad, Guro W. Angenete, Anna F. Johann, Bernd Feige, Kai Spiegelhalder, Dieter Riemann, Øystein Vedaa, Ståle Pallesen, Elisabeth Hertenstein |
| Summary: | Insomnia is prevalent among patients with alcohol use disorder (AUD), potentially undermining treatment and increasing the risk of relapse. Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for insomnia, but its efficacy is not well-characterized in patients across the spectrum of AUD. The aim of this meta-analysis was to quantify the effectiveness of CBT-I in improving insomnia severity and alcohol-related outcomes in adults with heavy alcohol use and/or varying levels of AUD severity and comorbid insomnia. MEDLINE, Cochrane Library, PsycINFO and ClinicalTrials.gov were systematically searched (up to February 2024) to retrieve randomized controlled trials (RCTs). Multilevel meta-analyses were conducted to estimate mean differences over time in insomnia severity, measured using the Insomnia Severity Index (ISI), as well as in alcohol craving and alcohol-related psychosocial problems between CBT-I and control groups. For the number of heavy-drinking/abstinent days, incidence rate ratios were estimated. Risk of bias was assessed using the Risk of Bias 2 (RoB 2) tool. Eight RCTs encompassing 426 adults (68.78 % men) were included. Compared with control conditions, CBT-I resulted in a large reduction of insomnia severity post-treatment [estimated ISI reduction = −5.51, 95% CI (−7.13 to −3.90)], which was maintained at 1-to-3-month [7 studies; estimate = −4.39, 95% CI (−6.08 to −2.70)], and 6-month follow-up [4 studies; estimate = −4.55, 95% CI (−6.77 to −2.33)]. Alcohol-related outcomes were reported less consistently, and no significant differences were found. The included trials were judged to have a low or moderate overall risk of bias for the assessment of all outcomes. CBT-I effectively reduces insomnia severity across the spectrum of AUD, supporting wide implementation in AUD prevention and treatment settings. - PROSPERO registration number - CRD42023464612. |
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| Item Description: | Online verfügbar: 11. Januar 2025, Artikelversion: 25. Januar 2025 Gesehen am 01.07.2025 |
| Physical Description: | Online Resource |
| ISSN: | 15322955 |
| DOI: | 10.1016/j.smrv.2025.102049 |