Korean J Adult Nurs.  2016 Feb;28(1):13-29. 10.7475/kjan.2016.28.1.13.

Effects of Non-pharmacological Interventions on Primary Insomnia in Adults Aged 55 and Above: A Meta-analysis

• Kim JH
• Oh PJ

• KMID: 2221705
• DOI: http://doi.org/10.7475/kjan.2016.28.1.13

Abstract

PURPOSE
This study was performed to evaluate the effects of non-pharmacological interventions on sleep disturbance amongst adults aged 55 and above.
METHODS
PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms including non-pharmacological interventions and presence of insomnia. Non-pharmacological interventions included cognitive behavioral therapy, auricular acupuncture, aromatherapy, and emotional freedom techniques. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.3 program of Cochrane Library.
RESULTS
Sixteen clinical trials met the inclusion criteria with a total of 962 participants. Non-pharmacological interventions was conducted for a mean of 5.5 weeks, 7.7 sessions, and an average of 70 minutes per session. The effects of non-pharmacological interventions on sleep quality (ES=-1.18), sleep efficiency (ES=-1.14), sleep onset latency (ES=-0.88), awakening time after sleep onset (ES=-0.87), and sleep belief (ES=-0.71) were significant, and their effect sizes were ranged from moderate to large. However, the effects on total sleep time and insomnia severity were not significant.
CONCLUSION
The findings of the current study suggest that non-pharmacological interventions have a positive impact on attitudes and beliefs about sleep, sleep quality, sleep duration, and sleep efficiency. Therefore, the findings of the study provide an evidence to incorporate various non-pharmacological interventions into nursing practice to improve both sleep quality and quantity in patients with insomnia.

MeSH Terms

Acupuncture, Ear
Adult*
Aromatherapy
Bias (Epidemiology)
Cognitive Therapy
Freedom
Humans
Clinical Trial
Nursing
Sleep Initiation and Maintenance Disorders*

Figure

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  Figure 1. Flow of studies included from database search.

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  Figure 2. Forest plot of effect size and 95% CI by non-pharmacological interventions on sleep onset latency, wake after sleep onset (WASO), and sleep efficiency.

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  Figure 3. Forest plot of effect size and 95% CI by non-pharmacological interventions on sleep quality and sleep belief.

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