Interventions for managing clinically relevant sleep disturbances or insomnia in cancer patients and survivors: an up-to-date systematic review and meta-analysis of self-reported sleep disturbance
Abstract
Background: Sleep disturbances are common after-effects of cancer. While the effectiveness of interventions in managing sleep disturbances in cancer have been evaluated, the effectiveness of interventions on reducing clinically relevant sleep disturbances remains unknown. This systematic review and meta-analysis aimed to appraise the effectiveness of up-to-date interventions managing clinical sleep disturbances in cancer patients or survivors.
Methods: Data from randomized controlled trials were analysed following PRISMA guidelines. Five English databases were searched from January 2012 to June 2025. Outcomes were measured using Hedge's g with random-effects models. The methodological quality of the trials was assessed by Cochrane Risk of Bias Tool 2.0 and the certainty of evidence was determined using GRADE.
Results: 42 trials with 3,844 participants were identified, with sample sizes ranging from 22 to 255. A moderate and large effect was found for cognitive behavioural therapy for insomnia (CBT-I) on improving sleep quality (g = 0.57; 95% CI = 0.20 - 0.93, p g = 0.91; 95% CI = 0.49 - 1.34, p g = 1.11; 95% CI = 0.43 - 1.78, p < 0.01) but indicated presence of publication bias. Other interventions, including mindfulness, exercise-based interventions, herbal medicine, relaxation and brief behavioural therapy for insomnia (BBT-I), showed less convincing evidence compared to CBT-I. Only one study scored low in overall risk of bias.
Conclusion: The existing evidence base needs…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 3,844 participants or records.
Read the paper
Related studies
- Tryptophan Metabolism and Gut-Brain Homeostasis
- Rationale for a Multi-Factorial Approach for the Reversal of Cognitive Decline in Alzheimer’s Disease and MCI: A Review
- Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit
- Relationship between sleep disorders and gut dysbiosis: what affects what?
- The role of CLOCK gene in psychiatric disorders: Evidence from human and animal research
- Genetic, Transcriptome, Proteomic, and Epidemiological Evidence for Blood-Brain Barrier Disruption and Polymicrobial Brain Invasion as Determinant Factors in Alzheimer’s Disease
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.