scholarly journals 241 Remotely Delivered Yoga Nidra for Insomnia and Anxiety during COVID-19

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A96-A96
Author(s):  
Erica Sharpe ◽  
Matthew Butler ◽  
Doug Hanes ◽  
Ryan Bradley
Keyword(s):  
Adult Population ◽  
Sleep Onset ◽  
Severity Index ◽  
Index Score ◽  
Average Score ◽  
Sleep Onset Latency ◽  
Post Intervention ◽  
Natural Medicine ◽  
National University ◽  
Yoga Nidra

Abstract Introduction Insomnia and related anxiety affect 30 - 50% of the US adult population. These conditions often coexist, and contribute to increased mortality from depression, heart disease, and stroke. The current COVID-19 pandemic has heightened anxiety and sleeplessness, and 53% of US adults report the pandemic has affected their mental health. There is a need for research into therapies for anxiety and insomnia that can be delivered remotely for increased accessibility to reach more individuals in need. Methods To contribute to this need, we examined the effects of remotely delivered Yoga Nidra (translated to mean “yogic sleep”), a guided meditation practice, on anxiety and sleep. The practice was delivered in real-time before bed, or asynchronously via an online REDCap-based platform, once per week for 16-weeks from April to July (during the early months of the COVID-19 pandemic). Results Seventy-four individuals joined the study, of whom 71% reported subthreshold insomnia (Insomnia Severity Index score of 14 ± 4), and 74% reported anxiety (Generalized Anxiety Disorder Index score of 10 ± 5). Seventy-one (96%) participants accessed the asynchronous recordings. Remote delivery of this practice proved very feasible, with no adverse events reported, and although we provided no monetary compensation, 50% of our sample still completed a post-intervention survey. Further, 52% of n=25 respondents who completed both pre- and post-intervention sleep surveys reported decreased sleep onset latency (SOL) the following day, with a mean decrease of 10 minutes (95% CI = −19.0, −0.5) for all respondents, and strongest change (−34 min; p=.017) measured for those who reported SOL between 30-120 min at baseline. Overall state anxiety was decreased by 41% for n=32 respondents who completed pre-post State Trait Anxiety Index (STAI) surveys surrounding a single practice (average score of 47 ± 11 before practice vs. 27 ± 8 after practice, p<.0001). Conclusion Remotely delivered Yoga Nidra is feasible to deliver, and demonstrates potential benefits for anxiety and insomnia, warranting additional research. Support (if any) This work was supported by the R90 BRIDG grant at the Helfgott Research Institute at the National University of Natural Medicine.

scholarly journals The Development of a Sleep Intervention for Firefighters: The FIT-IN (Firefighter’s Therapy for Insomnia and Nightmares) Study

2020 ◽  
Vol 17 (23) ◽  
pp. 8738
Author(s):  
Eun Hee Jang ◽  
Yujin Hong ◽  
Yeji Kim ◽  
Sangha Lee ◽  
Yeonsoon Ahn ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Sleep Onset ◽  
Severity Index ◽  
Sleep Diary ◽  
Sleep Onset Latency ◽  
Post Intervention ◽  
Sleep Diaries ◽  
Imagery Rehearsal Therapy ◽  
Time In Bed ◽  
Fire Stations

Background: Firefighters are vulnerable to irregular sleep patterns and sleep disturbance due to work characteristics such as shift work and frequent dispatch. However, there are few studies investigating intervention targeting sleep for firefighters. This preliminary study aimed to develop and test a sleep intervention, namely FIT-IN (Firefighter’s Therapy for Insomnia and Nightmares), which was based on existing evidence-based treatment tailored to firefighters in consideration of their occupational characteristics. Methods: This study implemented a single-group pre-post study design, utilizing an intervention developed based on brief behavior therapy for insomnia with imagery rehearsal therapy components. FIT-IN consisted of a total of three sessions (two face-to-face group sessions and one telephone session). Participants were recruited from Korean fire stations, and a total of 39 firefighters participated. Participants completed a sleep diary for two weeks, as well as the following questionnaires to assess their sleep and psychological factors: insomnia severity index (ISI), disturbing dream and nightmare severity index (DDNSI), Epworth sleepiness scale (ESS), depressive symptom inventory-suicidality subscale (DSI), and Patient Health Questionnaire-9 (PHQ-9). These questionnaires were administered before the first session and at the end of the second session. Results: The FIT-IN program produced improvements in sleep indices. There was a significant increase in sleep efficiency (p < 0.01), and a decrease in sleep onset latency, number of awakenings, and time in bed (p < 0.05), as derived from weekly sleep diaries. In addition, significant decreases were shown for insomnia (p < 0.001) and nightmare severity (p < 0.01). Conclusion: There were significant improvements in sleep and other clinical indices (depression, PTSD scores) when comparing pre-and post-intervention scores. FIT-IN may be a feasible and practical option in alleviating sleep disturbance in this population. Further studies will be needed to ascertain FIT-IN’s effectiveness.

scholarly journals Mindfulness-based therapy for insomnia for older adults with sleep difficulties: a randomized clinical trial

2021 ◽  
pp. 1-11
Author(s):  
Francesca Perini ◽  
Kian Foong Wong ◽  
Jia Lin ◽  
Zuriel Hassirim ◽  
Ju Lynn Ong ◽  
...  
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Exercise Program ◽  
Severity Index ◽  
Poor Sleep ◽  
Sleep Onset Latency ◽  
Post Intervention ◽  
Insomnia Severity

Abstract Objective Poor sleep is a modifiable risk factor for multiple disorders. Frontline treatments (e.g. cognitive-behavioral therapy for insomnia) have limitations, prompting a search for alternative approaches. Here, we compare manualized Mindfulness-Based Therapy for Insomnia (MBTI) with a Sleep Hygiene, Education, and Exercise Program (SHEEP) in improving subjective and objective sleep outcomes in older adults. Methods We conducted a single-site, parallel-arm trial, with blinded assessments collected at baseline, post-intervention and 6-months follow-up. We randomized 127 participants aged 50–80, with a Pittsburgh Sleep Quality Index (PSQI) score ⩾5, to either MBTI (n = 65) or SHEEP (n = 62), both 2 hr weekly group sessions lasting 8 weeks. Primary outcomes included PSQI and Insomnia Severity Index, and actigraphy- and polysomnography-measured sleep onset latency (SOL) and wake after sleep onset (WASO). Results Intention-to-treat analysis showed reductions in insomnia severity in both groups [MBTI: Cohen's effect size d = −1.27, 95% confidence interval (CI) −1.61 to −0.89; SHEEP: d = −0.69, 95% CI −0.96 to −0.43], with significantly greater improvement in MBTI. Sleep quality improved equivalently in both groups (MBTI: d = −1.19; SHEEP: d = −1.02). No significant interaction effects were observed in objective sleep measures. However, only MBTI had reduced WASOactigraphy (MBTI: d = −0.30; SHEEP: d = 0.02), SOLactigraphy (MBTI: d = −0.25; SHEEP: d = −0.09), and WASOPSG (MBTI: d = −0.26; SHEEP (d = −0.18). There was no change in SOLPSG. No participants withdrew because of adverse effects. Conclusions MBTI is effective at improving subjective and objective sleep quality in older adults, and could be a valid alternative for persons who have failed or do not have access to standard frontline therapies.

scholarly journals Effect of early intervention for anxiety on sleep outcomes in adolescents: a randomized trial

2021 ◽  
Author(s):  
Bente Storm Mowatt Haugland ◽  
Mari Hysing ◽  
Asle Hoffart ◽  
Åshild Tellefsen Haaland ◽  
Jon Fauskanger Bjaastad ◽  
...  
Keyword(s):  
Early Intervention ◽  
Standard Length ◽  
Sleep Problems ◽  
Sleep Onset ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Sleep Onset Latency ◽  
Post Intervention ◽  
Clinical Trial Registration

AbstractThe potential effect of early intervention for anxiety on sleep outcomes was examined in a sample of adolescents with anxiety (N = 313, mean 14.0 years, SD = 0.84, 84% girls, 95.7% Norwegians). Participants were randomized to one of three conditions: a brief or a standard-length cognitive-behavioral group-intervention (GCBT), or a waitlist control-group (WL). Interventions were delivered at schools, during school hours. Adolescents with elevated anxiety were recruited by school health services. Questionnaires on self-reported anxiety symptoms, depressive symptoms, and sleep characteristics were administered at pre- and post-intervention, post-waitlist, and at 1-year follow-up. Adolescents reported reduced insomnia (odds ratio (OR) = 0.42, p < 0.001) and shorter sleep onset latency (d = 0.27, p <  0.001) from pre- to post-intervention. For insomnia, this effect was maintained at 1-year follow-up (OR = 0.54, p = 0.020). However, no effect of GCBT on sleep outcomes was found when comparing GCBT and WL. Also, no difference was found in sleep outcomes between brief and standard-length interventions. Adolescents defined as responders (i.e., having improved much or very much on anxiety after GCBT), did not differ from non-responders regarding sleep outcomes. Thus, anxiety-focused CBT, delivered in groups, showed no effect on sleep outcomes. Strategies specifically targeting sleep problems in adolescents should be included in GCBT when delivered as early intervention for adolescents with elevated anxiety.Trial registry Clinical trial registration: School Based Low-intensity Cognitive Behavioral Intervention for Anxious Youth (LIST); http://clinicalrials.gov/; NCT02279251, Date: 11.31. 2014

scholarly journals 0916 The Use of Immersive Virtual Reality and Slow Breathing to Enhance Relaxation and Sleep in Adolescents

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A348-A348
Author(s):  
D Yüksel ◽  
A Goldstone ◽  
D Prouty ◽  
M Forouzanfar ◽  
S Claudatos ◽  
...  
Keyword(s):  
Heart Rate ◽  
Virtual Reality ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Apparent Difference ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Post Intervention ◽  
Falling Asleep ◽  
Slow Breathing

Abstract Introduction Sleep disturbances frequently emerge during adolescence amongst profound, normative, sleep maturation and biopsychosocial changes. Factors like stress, worry or rumination may make falling asleep and maintaining sleep more difficult. Here, we evaluate the efficacy of a novel intervention based on virtual reality (VR) and slow breathing to promote bedtime relaxation and facilitate sleep in high-school adolescents. Methods Twenty-nine 16-18 year-old adolescents with (N=9, 6 girls) and without (N=20, 11 girls) sleep difficulties underwent two counterbalanced in-lab relaxation and baseline polysomnography (PSG) nights. For the relaxation condition, immediately preceding bedtime, participants were engaged in slow diaphragmatic breathing (to promote physiological downregulation) whilst passively experiencing a relaxation immersive VR environment, designed to promote cognitive relaxation/distraction (20min). On the baseline night, participants engaged in quiet activities (e.g., reading a book) before bedtime (20min). Results The VR intervention resulted in a significant immediate increase in perceived relaxation and reduced worry (p&lt;0.05). Also, heart rate dropped (~5bpm) in the pre-to-post intervention (p&lt;0.05), while no significant change in heart rate was evident before and after the time spent in quiet activities on the baseline night. PSG-defined sleep onset latency was shorter (~6min reduction) and sleep efficiency was greater (~3% increase) on the VR relaxation night compared to the baseline night (p&lt;0.05). In addition, baseline sleep onset latency was related to the magnitude of the baseline-to-relaxation reduction in sleep onset latency in participants (R2=0.70; p&lt;0.01). There was no apparent difference in responses to the VR intervention between adolescents with or without insomnia. Conclusion Our data highlight the potential for combining cognitive relaxation/distraction strategies, using immersive VR technology and physiological downregulation, to promote bedtime relaxation and improve overall sleep quality in adolescents. Further research is needed to evaluate the feasibility and effectiveness of such interventions over time. Support National Heart, Lung and Blood Institute (NHLBI) R01HL139652 (to MdZ)

A Closer Look at Yoga Nidra: Sleep Lab Protocol

2020 ◽  
Author(s):  
Erica Sharpe ◽  
Alison Lacombe ◽  
Matthew P. Butler ◽  
Douglas Hanes ◽  
Ryan Bradley
Keyword(s):  
Sleep Disorders ◽  
Sleep Onset ◽  
Sleep Time ◽  
The United States ◽  
Sleep Onset Latency ◽  
Measurement Systems ◽  
All Cause Mortality ◽  
Increasing Risk ◽  
Yoga Nidra ◽  
Body Practices

Abstract Extended sleep onset latency (SOL), or “sleep onset insomnia,” can decrease total sleep time, increasing risk for many health conditions, including heart disease, stroke, and all-cause mortality. Sleep disorders persist in the United States despite current behavioral/pharmaceutical remedies, with 10% to 15% of the population suffering from insomnia. Mind-body therapies offer additional solutions, as meditation has been correlated with decreased SOL. More research on use of mind-body practices for insomnia is needed. This study investigates the guided meditation practice of Yoga Nidra (yogic sleep) as a promising intervention for sleep disorders because of its purported ability to induce mental, physical, and emotional relaxation. In this pilot study, we address the feasibility of Yoga Nidra for insomnia, appropriateness of our selected measurement systems, and effect of Yoga Nidra on brainwaves, sleep onset, and the autonomic nervous system. Our study sample includes 22 adults, ages 18–45, with insomnia. The design includes two clinic visits (V1, lying quietly for 90 min; V2, randomization to 90-min lying quietly vs. 30-min Yoga Nidra plus 60-min lying quietly), taking place 1 to 14 days apart. Outcomes measured during/after Yoga Nidra (vs. control) include sleep onset, electroencephalography (EEG) power, heart rate variability (HRV), and respiratory rate. Self-reported mood and anxiety will be measured before/after each visit. Resulting physiological, psychological, and feasibility data will be used to inform future clinical studies of Yoga Nidra for sleep and relaxation.

scholarly journals Assessing sleep quality in older adults: A comparison of three measurement approaches

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 882-882
Author(s):  
Amy Berkley ◽  
Patricia Carter
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Assessment Tool ◽  
Sleep Problems ◽  
Adult Population ◽  
Sleep Onset ◽  
Self Report ◽  
Sleep Onset Latency ◽  
Wrist Actigraphy ◽  
Sleep Assessment

Abstract Discrepancies between subjective and objective sleep measures have been reported for some time; however, it is critical to consider the implications of inaccurate or incomplete sleep assessment for frail older adults who are struggling to maintain independence. To compare sleep assessment methods, we collected objective sleep measurements (via wrist actigraphy), subjective measures via self-report sleep surveys (Pittsburgh Sleep Quality Index; Insomnia Severity Index, Sleep Hygiene Index), and qualitative data through semi-structured audio-recorded interviews, from 8 older adults who self-reported sleep problems while living in a retirement community in southwestern US. Participants’ objective sleep (Total Sleep Time, Sleep Onset Latency, Wake After Sleep Onset, and Sleep Efficiency) and qualitative narratives were congruent, but self-report measures failed to capture several unique sleep problems identified in the sample. Disordered sleep in older adults has been linked to increased incidence of falls, depression and anxiety, cognitive impairment, institutionalization, and mortality, but traditional sleep assessment instruments, designed for the general adult population, fail to capture many of the experiences and causes that are unique to older adults. functioning. A sleep assessment tool designed to measure older people’s sleep experiences could provide more accurate and sensitive data.

scholarly journals Oral magnesium supplementation for insomnia in older adults: a Systematic Review & Meta-Analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jasmine Mah ◽  
Tyler Pitre
Keyword(s):  
Older Adults ◽  
Grey Literature ◽  
Sleep Onset ◽  
Risk Of Bias ◽  
Sleep Onset Latency ◽  
Post Intervention ◽  
Magnesium Supplementation ◽  
Quality Of Evidence ◽  
Oral Magnesium

Abstract Background Magnesium supplementation is often purported to improve sleep; however, as both an over-the-counter sleep aid and a complementary and alternative medicine, there is limited evidence to support this assertion. The aim was to assess the effectiveness and safety of magnesium supplementation for older adults with insomnia. Methods A search was conducted in MEDLINE, EMBASE, Allied and Complementary Medicine, clinicaltrials.gov and two grey literature databases comparing magnesium supplementation to placebo or no treatment. Outcomes were sleep quality, quantity, and adverse events. Risk of bias and quality of evidence assessments were carried out using the RoB 2.0 and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approaches. Data was pooled and treatment effects were quantified using mean differences. For remaining outcomes, a modified effects direction plot was used for data synthesis. Results Three randomized control trials (RCT) were identified comparing oral magnesium to placebo in 151 older adults in three countries. Pooled analysis showed that post-intervention sleep onset latency time was 17.36 min less after magnesium supplementation compared to placebo (95% CI − 27.27 to − 7.44, p = 0.0006). Total sleep time improved by 16.06 min in the magnesium supplementation group but was statistically insignificant. All trials were at moderate-to-high risk of bias and outcomes were supported by low to very low quality of evidence. Conclusion This review confirms that the quality of literature is substandard for physicians to make well-informed recommendations on usage of oral magnesium for older adults with insomnia. However, given that oral magnesium is very cheap and widely available, RCT evidence may support oral magnesium supplements (less than 1 g quantities given up to three times a day) for insomnia symptoms.

scholarly journals O028 Effectiveness of digital brief behavioural therapy for insomnia with wearable technology: pilot randomized controlled trial

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A13-A13
Author(s):  
C Gordon ◽  
M Aji ◽  
N Glozier ◽  
D Bartlett ◽  
R Calvo ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Pilot Trial ◽  
Sleep Onset ◽  
Severity Index ◽  
Sleep Time ◽  
Behavioural Therapy ◽  
Wearable Device ◽  
User Engagement ◽  
Sleep Onset Latency ◽  
Significant Difference

Abstract Objective This pilot trial aimed to test the effectiveness of integration of a wearable device with digital brief behavioural therapy for insomnia (dBBTi) on insomnia symptom severity, sleep metrics and therapy engagement. Participants and Methods One hundred and twenty-eight participants with insomnia symptoms were randomised to a 3-week dBBTi program with a wearable device enabling sleep data synchronization (dBBTi+wearable group; n = 62) or dBBTi alone (n = 66). We assessed the Insomnia Severity Index (ISI) and modified Pittsburgh Sleep Quality Index (PSQI; wake-after-sleep-onset (WASO), sleep-onset-latency (SOL), and total sleep time (TST)) at baseline and weeks 1, 2, 3, 6 and 12. Engagement was measured by the number of daily sleep diaries. Results There was no significant difference in ISI scores between the groups (d = 0.7, p = 0.061). The dBBTi+wearable group showed greater improvements in WASO (d = 0.8, p = 0.005) and TST (d = 0.3, p = 0.049) compared to the dBBTi group after 6 weeks. There was significantly greater engagement in the dBBTi+wearable group compared to the dBTi group (d =0.7, p = 0.010). Conclusions This pilot trial found that wearable device integration with a digital insomnia therapy led to improvements in WASO and TST and enhanced user engagement. We suggest that incorporation of adjunctive wearable technologies may improve digital insomnia therapy.

scholarly journals 0931 Parenting Stress Can Be Predicted by Parent and Child Sleep, and Can Be Reduced by an Intervention Targeting Child Sleep in Vulnerable Families

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A354-A354
Author(s):  
J Potvin ◽  
K Mercier ◽  
A Bérubé ◽  
N Raymond ◽  
G Forest
Keyword(s):  
Parenting Stress ◽  
Family Income ◽  
Short Form ◽  
Sleep Onset ◽  
Stress Index ◽  
Sleep Onset Latency ◽  
Sleep Habits ◽  
Post Intervention ◽  
Child Sleep ◽  
Vulnerable Families

Abstract Introduction Studies suggest that family intervention programs should consider different sources of parenting stress (PS). Knowing that child sleep has an impact on PS, this study aimed to examine if a child sleep intervention can affect PS in vulnerable families. Methods In a first study, parent and child sleep habits along with PS were assessed using Parenting Stress Index-Short Form, Pittsburgh Sleep Quality Index and homemade questions assessing child sleep. Measures were administered to 138 community mothers (children 3-79 months). Multiple linear regression analyses examined mothers and child sleep associations to PS, controlled by family income. Following results of this first study, 11 vulnerable mothers (children 39-68 months) participated in a child sleep intervention specifically developed for vulnerable families. Measures administered were the same as for study 1, but in this study, the Child Sleep Habits Questionnaire was used to assess the child sleep. Wilcoxon’s t-test compared pre and post-intervention measures. Results In the first study, sleep onset latency (SOL; β= -.25; p= .003), waketime (β= -.28; p= .003) and sleep aids (β= -.19; p= .048) explained 23.6% of PS variance. When child sleep variables were added to the model, only bedtime resistance was significant (β= -.23; p= .023) and increased the explained variance to 30.6%. Following the child sleep intervention, no significant changes in parent sleep were observed. However, results show improvement of child bedtime resistance (Mpre=10.73; Mpost=8.36; p= .027) and PS (Mpre=3.50; Mpost=3.82; p= .05). Conclusion Our results suggest that higher PS is explained by greater struggles in parents sleep (higher SOL, later waketime and higher use of sleep aids) as well as bedtime resistance behaviors in children. Furthermore, PS can be reduced by an intervention improving child bedtime resistance, even if parent sleep is not improved. Support  

scholarly journals Efficacy of Face-to-Face Delivered Cognitive Behavioral Therapy in Improving Health Status of Patients With Insomnia: A Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Dawei Xu ◽  
Elizabeth Cardell ◽  
Simon A. Broadley ◽  
Jing Sun
Keyword(s):  
Sleep Quality ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Sleep Onset ◽  
Intervention Group ◽  
Severity Index ◽  
Sleep Time ◽  
Control Group ◽  
Sleep Onset Latency ◽  
Face To Face

Background: Face-to-face cognitive behavioral therapy (CBT) is one of the most widely used non-pharmacological treatment approaches for insomnia. The aim of this study is to assess the efficacy of face-to-face delivered CBT on health outcomes and to evaluate the effect of CBT components as subgroup variables to explain the efficacy of face-to-face delivered CBT on health outcomes in adults over 18 years old with insomnia.Methods: Relevant randomized controlled trial studies published in the past 22 years were searched through the electronic databases. The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality of the 31 included studies. The mean difference and standard deviation of outcome variables and subgroup variables were analyzed using random effect model, and the heterogeneity among the articles was assessed with the Q-test and I2. Egger regression analysis was used to assess publication bias.Results: The meta-analysis showed a significant reduction in Insomnia Severity Index [standardized mean difference (SMD) = −2.56, 95% CI −3.81 to −1.30, p &lt; 0.001], Pittsburgh Sleep Quality Index (SMD = −0.96, 95% CI −1.25 to −0.68, p &lt; 0.001), sleep onset latency (SMD = −1.31, 95% CI −2.00 to −0.63, p &lt; 0.001), wakening after sleep onset (SMD = −1.44, 95% CI −2.14 to −0.74, p &lt; 0.001), number of awakenings (SMD = −1.18, 95% CI −2.10 to −0.26, p &lt; 0.05), depression (SMD = −1.14, 95% CI −1.85 to −0.42, p &lt; 0.01), and fatigue (SMD = −2.23, 95% CI −3.87 to −0.58, p &lt; 0.01), and a significant increase in total sleep time (SMD = 0.63, 95% CI 0.28 to 0.98, p &lt; 0.001), sleep efficiency (SMD = 1.61, 95% CI 0.92 to 2.29, p &lt; 0.001), and physical health (SMD = 0.42, 95% CI 0.08 to 0.76, p &lt; 0.05), in the CBT intervention group compared with the control group. There was no significant change in anxiety (SMD = −0.62, 95% CI −1.55 to 0.32, p &gt; 0.05) and mental health (SMD = 1.09, 95% CI −0.59 to 2.77, p &gt; 0.05) in CBT intervention group compared with control group. Group-delivered studies with larger number of intervention sessions and longer duration of single session provided a larger improvement in sleep quality.Conclusion: Face-to-face delivered CBT is effective in increasing total sleep time, sleep efficiency, and physical health, and reducing Insomnia Severity Index scores, Pittsburgh Sleep Quality Index scores, sleep onset latency, wakening after sleep onset, number of awakenings, depression, anxiety, and fatigue in patients with insomnia. Face-to-face delivered CBT is more effective when delivered through a larger number of sessions with longer duration of each session, and when delivered in groups. Face-to-face CBT is recommended to provide treatment to patients with insomnia in clinical settings.Systematic Review Registration:www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020200091, identifier: CRD4202020009.

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