BMC medicine · 2026
Effects of non-pharmacological interventions on sleep quality in older adults: a systematic review and network meta-analysis of randomized controlled trials.
Систематический обзорСтатьяNetwork Meta-AnalysisНазвание и аннотация: Перевод в очереди
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Song Jia, Dong Heng, Wang Chunying, Zheng Yanxi, Huang Yangzhen, Wei Yilin, Zhang Kangkang, Qing Hua, Xiong Zhongbao, Pan Yangyang, Chen Manwei, Kang Ruizhe, Ghose Bishwajit, Tang Dongfeng, Wang Ruoxi, Long Chengxu, Li Yunfei, Tang Shangfeng
Аннотация
BACKGROUND: Sleep problems are common among older adults and are associated with a wide range of adverse health outcomes. Concerns about pharmacological treatments have increased interest in non-pharmacological interventions; however, evidence comparing their relative effectiveness remains limited.
METHODS: A systematic search was conducted in PubMed, Scopus, Embase, Web of Science, Cochrane Library, and CINAHL. Randomized controlled trials (RCTs) evaluating non-pharmacological interventions in adults aged ≥ 60 years published between 2000 and 2024 were included. Network meta-analyses were conducted using random-effects models to estimate standardized mean differences (SMDs) with 95% confidence intervals (CIs). P-scores were used to rank the efficacy of interventions. The protocol was registered in PROSPERO (CRD42024521492).
RESULTS: Thirty-four RCTs involving 3078 participants and 21 interventions were included. Eleven interventions significantly improved sleep quality. Cognitive behavioral therapy for insomnia plus positive mood strategies (CBT-I+) showed the largest effect (P-score = 0.99, SMD = - 3.32, 95% CI - 4.59 to - 2.06), followed by cognitive behavioral therapy for insomnia (CBT-I) (P-score = 0.92, SMD = - 2.18, 95% CI - 3.04 to - 1.31). Subgroup analyses indicated that music therapy (MUS) was more effective among participants with PSQI < 10 (SMD = - 1.25, 95% CI - 1.85 to - 0.65), whereas CBT-I+ showed greater effects for those with PSQI ≥ 10 (SMD = - 5.48, 95% CI - 6.80 to - 4.16). By intervention setting, traditional Chinese health-promotion exercise (TCHPE) was more effective in home-based settings (SMD = - 1.55, 95% CI - 2.60 to - 0.50), whereas CBT-I+ showed greater effects in non-home settings (SMD = - 3.31, 95% CI - 4.57 to - 2.06).
CONCLUSIONS: CBT-I+ was associated with the greatest improvements in sleep quality among older adults, particularly those with baseline PSQI ≥ 10 and in non-home settings. MUS showed greater benefits among older adults with baseline PSQI < 10, and TCHPE showed greater benefits in home-based settings. These findings support stratified, context-specific intervention selection. Given the low GRADE certainty, these results should be interpreted with caution.
METHODS: A systematic search was conducted in PubMed, Scopus, Embase, Web of Science, Cochrane Library, and CINAHL. Randomized controlled trials (RCTs) evaluating non-pharmacological interventions in adults aged ≥ 60 years published between 2000 and 2024 were included. Network meta-analyses were conducted using random-effects models to estimate standardized mean differences (SMDs) with 95% confidence intervals (CIs). P-scores were used to rank the efficacy of interventions. The protocol was registered in PROSPERO (CRD42024521492).
RESULTS: Thirty-four RCTs involving 3078 participants and 21 interventions were included. Eleven interventions significantly improved sleep quality. Cognitive behavioral therapy for insomnia plus positive mood strategies (CBT-I+) showed the largest effect (P-score = 0.99, SMD = - 3.32, 95% CI - 4.59 to - 2.06), followed by cognitive behavioral therapy for insomnia (CBT-I) (P-score = 0.92, SMD = - 2.18, 95% CI - 3.04 to - 1.31). Subgroup analyses indicated that music therapy (MUS) was more effective among participants with PSQI < 10 (SMD = - 1.25, 95% CI - 1.85 to - 0.65), whereas CBT-I+ showed greater effects for those with PSQI ≥ 10 (SMD = - 5.48, 95% CI - 6.80 to - 4.16). By intervention setting, traditional Chinese health-promotion exercise (TCHPE) was more effective in home-based settings (SMD = - 1.55, 95% CI - 2.60 to - 0.50), whereas CBT-I+ showed greater effects in non-home settings (SMD = - 3.31, 95% CI - 4.57 to - 2.06).
CONCLUSIONS: CBT-I+ was associated with the greatest improvements in sleep quality among older adults, particularly those with baseline PSQI ≥ 10 and in non-home settings. MUS showed greater benefits among older adults with baseline PSQI < 10, and TCHPE showed greater benefits in home-based settings. These findings support stratified, context-specific intervention selection. Given the low GRADE certainty, these results should be interpreted with caution.