Online interventions for reducing anxiety, depression, and stress among adolescents: A systematic review and meta-analysis (Preprint)

2021 ◽  
Author(s):  
Dabok Noh ◽  
Hyunlye Kim
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Meta Analysis ◽  
Online Intervention ◽  
Cochrane Library ◽  
Universal Prevention ◽  
Online Interventions ◽  
Meta Analyses ◽  
Anxiety Depression ◽  
Selective Prevention

BACKGROUND As the coronavirus 2019 disease pandemic has emerged as a threat to mental health, demand is increasing for online interventions that can replace face-to-face programs to prevent mental health problems. Adolescents not only have willingness to use an online mental health intervention, but also have generally positive perceptions of online intervention. However, there is still no general agreement regarding the effects of online interventions on adolescent mental health. OBJECTIVE This study aimed to evaluate the effectiveness of online interventions for reducing anxiety, depression, and stress among adolescents through a systematic review and meta-analysis. METHODS A systematic search of studies was performed using PubMed, EMBASE, and Cochrane Library CENTRAL. The Cochrane Collaboration’s tool was used for assessing risk of bias in randomized controlled trials (RCT). We performed meta-analyses to synthesize effect sizes of the included studies, which were calculated as standardized mean differences (SMD) with 95% confidence intervals (CI). RESULTS A total of 19 studies met the inclusion criteria, and 16 studies that reported sufficient numerical data were used for quantitative data synthesis. Regarding prevention level in the included interventions, universal prevention for general adolescents and selective prevention for vulnerable adolescents were conducted by 12 and seven studies, respectively. Among the interventions in this review, cognitive behavior therapy (CBT) and family-based interventions were most often used. In the result of a meta-analysis, online interventions have shown beneficial effect on reducing depression (SMD, -0.096; 95% CI. -0.175 to -0.017). Subgroup meta-analyses by preventive level found a significant effect of universal prevention on reducing depression (SMD, -0.102; 95% CI, -0.197 to -0.008) but no statistically significant effect of selective prevention on reducing depression (SMD, -0.082; 95% CI, -0.224 to 0.061). The effects of online interventions in reducing anxiety (SMD, -0.107; 95% CI, -0.231 to 0.018) and stress (SMD, -0.071; 95% CI, -0.157 to 0.016) among adolescents were not statistically significant in meta-analyses. CONCLUSIONS The findings of meta-analyses showed that online interventions significantly reduced depression among adolescents, and especially that universal prevention interventions significantly reduced depression. However, there is limited evidence for the effectiveness of online interventions for reducing anxiety and stress among adolescents. We suggest further RCTs regarding effectiveness of online intervention for adolescent anxiety and stress.

scholarly journals Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis

2019 ◽  
Vol 53 (11) ◽  
pp. 700-706 ◽  
Author(s):  
Vincent Gouttebarge ◽  
João Mauricio Castaldelli-Maia ◽  
Paul Gorczynski ◽  
Brian Hainline ◽  
Mary E Hitchcock ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Alcohol Misuse ◽  
Elite Athletes ◽  
Meta Analysis ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Meta Analyses ◽  
Former Elite Athletes ◽  
Anxiety Depression

ObjectivesTo present an overview of the existing epidemiological evidence regarding the occurrence of mental health symptoms and disorders among current and former elite athletes.DesignSystematic review and meta-analysis.Data sourcesFive electronic databases were searched from inception to November 2018: PubMed (MEDLINE), SportDiscus via EBSCO, PSycINFO via ProQuest, Scopus and Cochrane.Eligibility criteria for selecting studiesWe included original quantitative studies that were written in English, were conducted exclusively among current or former elite athletes, and presented incidence or prevalence rates of symptoms of mental disorders.ResultsTwenty-two relevant original studies about mental health symptoms and disorders among current elite athletes were included: they presented data especially on symptoms of distress, sleep disturbance, anxiety/depression and alcohol misuse. Meta-analyses comprising 2895 to 5555 current elite athletes showed that the prevalence of mental health symptoms and disorders ranged from 19% for alcohol misuse to 34% for anxiety/depression. Fifteen relevant original studies about mental health symptoms and disorders among former elite athletes were included: they similarly presented data especially about symptoms of distress, sleep disturbance, anxiety/depression and alcohol misuse. Meta-analyses comprising 1579 to 1686 former elite athletes showed that the prevalence of mental health symptoms and disorders ranged from 16% for distress to 26% for anxiety/depression.ConclusionsOur meta-analyses showed that the prevalence of mental health symptoms and disorders ranged from 19% for alcohol misuse to 34% for anxiety/depression for current elite athletes, and from 16% for distress to 26% for anxiety/depression for former elite athletes.

scholarly journals Is music listening an effective intervention for reducing anxiety? A systematic review and meta-analysis of controlled studies

2022 ◽  
pp. 102986492110469
Author(s):  
Cristina Harney ◽  
Judith Johnson ◽  
Freya Bailes ◽  
Jelena Havelka
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Mental Health Disorder ◽  
Anxiety Reduction ◽  
Cochrane Library ◽  
Music Listening ◽  
Ovid Medline ◽  
Meta Analyses

Anxiety is the most commonly diagnosed mental health disorder in the EU and 18% of the US population experiences an anxiety disorder at any one time. However, only 20% of individuals experiencing anxiety receive a formally administered intervention, highlighting a need for evidence-based interventions that can be self-administered. Music listening can be flexibly self-administered and may be useful for anxiety reduction, but further evidence is needed. The current paper addressed this by conducting the first systematic review and meta-analysis of controlled studies testing music listening interventions for naturally occurring state anxiety. A protocol was registered on PROSPERO ID: CRD42018104308. Searches were carried out of the Cochrane Library, Ovid MEDLINE, PsycINFO, Embase, Web of Science and CINAHL databases, yielding 6208 records. After screening for eligibility, 24 controlled studies were included in the review and 21 were included in the meta-analysis. Results of the meta-analyses showed that music listening had an overall significant large effect on alleviating anxiety ( d = −0.77 [95% CI = −1.26, −0.28], k = 21). It was concluded that music listening is effective for reducing anxiety in a range of groups. Further research should focus on clinical groups with diagnosed mental health problems.

Effects of mobile mindfulness meditation on mental health of university students: Systematic review and meta-analysis (Preprint)

2021 ◽  
Author(s):  
Hong Chen ◽  
Bin Chen ◽  
Ting Yang
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
University Students ◽  
Mindfulness Meditation ◽  
Meta Analysis ◽  
Well Being ◽  
Cochrane Library ◽  
Control Groups ◽  
Registration Number ◽  
Anxiety Depression

BACKGROUND Mobile mindfulness meditation (MMM) is mindfulness meditation intervention implemented by mobile devices like smart phones and apps. MMM has been used to help managing mental health of university students. OBJECTIVE The purpose of this study was to evaluate the effectiveness of MMM on mental health of university students in the areas of stress, anxiety, depression, mindfulness, well-being, and resilience. METHODS We conducted a systematic review and meta-analysis of the effectiveness of MMM on mental health of university students. An electronic literature search using the PubMed, Web of Science, EBSCO, Cochrane Library, and EMBASE from inception to July 16, 2021 was conducted to identify studies that reported the effects of MMM on stress, anxiety, depression, mindfulness, well-being, and resilience. Two reviewers retrieved articles, evaluated quality and extracted data independently. The methodological quality of the selected studies was determined using the Cochrane criteria for risk-of-bias assessment. The RevMan Version 5.3 was used to perform meta-analysis. RESULTS A total of 10 studies, including 958 university students, were selected for meta-analysis. Results showed that MMM was more effective than the control groups in decreasing stress (SMD=-0.41, 95% CI [-0.59, -0.23], P<0.0001), alleviating anxiety (SMD=-0.29, 95% CI [-0.50, -0.09], P=0.004), enhancing well-being (SMD=0.30, 95% CI [0.11, 0.50], P=0.003), and improving mindfulness (SMD=2.66, 95% CI [0.77, 4.55], P=0.006). However, there was no difference between MMM and the control groups in depression (SMD=-0.14, 95% CI [-0.30, 0.03], P=0.11), and resilience (SMD=-0.06, 95% CI [-0.26, 0.15], P=0.59). CONCLUSIONS MMM was an effective method to reduce stress, anxiety, and to increase well-being, mindfulness of university students, further studies are needed to confirm our findings. CLINICALTRIAL review article, no trail registration number.

scholarly journals One Year of Evidence on Mental Health in the COVID-19 Crisis - A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Xi Chen ◽  
Jiyao Chen ◽  
Meimei Zhang ◽  
Richard Z. Chen ◽  
Rebecca Kechen Dong ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Healthcare Workers ◽  
Meta Analysis ◽  
Prevalence Rates ◽  
Meta Regression ◽  
One Year ◽  
Meta Analyses ◽  
Frontline Healthcare Workers ◽  
Anxiety Depression

ABSTRACTObjectiveThis paper provides a systematic review and meta-analysis on the prevalence rate of mental health issues of the major population, including general population, general healthcare workers (HCWs), and frontline healthcare workers (HCWs), in China over one year of the COVID-19 crisis.DesignA systematic review and meta-analysis.Data sourcesarticles in PubMed, Embase, Web of Science, and medRxiv up to November 16, 2020, one year after the first publicly known confirmed COVID-19 case.Eligibility criteria and data analysisany COVID-19 and mental disorders relevant English studies with frontline/general healthcare workers, general adult population sample, using validated scales. We pooled data using random-effects meta-analyses to estimate the prevalence rates of anxiety, depression, distress, general psychological symptoms (GPS), insomnia, and PTSD and ran meta-regression to tease out the heterogeneity.ResultsThe meta-analysis includes 131 studies and 171 independent samples. The overall prevalence of anxiety, depression, distress, GPS, insomnia, and PTSD are 11%, 13%, 20%, 13%, 19%, and 20%, respectively. The meta-regression results uncovered several predictors of the prevalence rates, including severity (e.g., above severe vs. above moderate, p<0.01; above moderate vs. above mild, p<0.01) and type of mental issues (e.g., depression vs. anxiety, p=0.04; insomnia vs. anxiety p=0.04), population (frontline HCWs vs. general HCWs, p<0.01), sampling location (Wuhan vs. non-Wuhan, p=0.04), and study quality (p=0.04).LimitationsFirst, we only focus on China population, which may limit the generalizability of the results. Second, 96.2% studies included in this meta-analysis were cross-sectional. Last, since we only included studies published in English, we expect to have a language bias.ConclusionOur pooled prevalence rates are significantly different from, yet largely between, the findings of previous meta-analyses, suggesting the results of our larger study are consistent with, yet fine-tune, the findings of the smaller, previous meta-analyses. Hence, this meta-analysis not only provides a significant update on the mental health prevalence rates in COVID-19 but also suggests the need to update meta-analyses continuously to provide more accurate estimates of the prevalence of mental illness during this ongoing health crisis. While prior meta-analyses focused on the prevalence rates of mental health disorders based on one level of severity (i.e., above mild), our findings also suggest a need to examine the prevalence rates at varying levels of severity. The one-year cumulative evidence on sampling locations (Wuhan vs. non-Wuhan) corroborates the typhoon eye effect theory. Our finding that the prevalence rates of distress and insomnia and those of frontline healthcare workers are higher suggest future research and interventions should pay more attention to those mental outcomes and populations.

scholarly journals Burden of predominant psychological reactions among the healthcare workers and general during COVID-19 pandemic phase: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Bhaskar Thakur ◽  
Mona Pathak
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Healthcare Workers ◽  
Global Mental Health ◽  
Meta Analysis ◽  
Random Effect ◽  
Anxiety And Depression ◽  
Psychological Reactions ◽  
Frontline Healthcare Workers ◽  
Anxiety Depression

ABSTRACTAimPresent systematic review and meta-analysis examined the burden of psychological reactions predominantly anxiety, depression, stress and insomnia during novel COVID-19 pandemic phase among the frontline healthcare, non-frontline healthcare and general.MethodologyPubMed, EMBASE and SCOPUS were searched for studies between Jan 1, 2020 to May 25, 2020. Brief protocol of the systematic review was registered with the PROSPERO database, (CRD42020186229).Any study that reported the burden of at least one of psychological reactions including anxiety or depression or stress or insomnia was eligible. Heterogeneity was assessed using I2 statistic and results were synthesized using random effect meta-analysis.ResultsOut of 52eligible studies, 43 reported anxiety, 43 reported depression, 20 reported stress and 11 reported insomnia. Overall prevalence for anxiety, depression, stress and insomnia were 26.6%, 26.2%,26.2% and 34.4% respectively. Anxiety and depression were found highest among the COVID-19 patients (43.3% and 51.75 respectively). Apart from COVID-19 patients, prevalence of anxiety, depression, stress and insomnia were found highest among the frontline healthcare (27.2%, 32.1%,55.6% and 34.4% respectively) as compared to general healthcare workers (26.9%, 15.7%, 7.0% and 34.0% respectively) and general population (25.9%, 25.9%,25.4% and 29.4% respectively).ConclusionAnxiety and depression were found highest among the COVID-19 patients. Apart from COVID-19 patients, the anxiety, depression, stress and insomnia were more prevalent among frontline healthcare workers compared to general. Such increased prevalence is prompting towards the global mental health emergency. Therefore a call of urgent attention and pan-region effective mental-health intervention are required to mitigate these psychological reactions.

The Prevalence of Technology-Facilitated Sexual Violence: A Meta-Analysis and Systematic Review

2020 ◽  
pp. 152483802095805
Author(s):  
Unnati Patel ◽  
Ronald Roesch
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Sexual Violence ◽  
Meta Analysis ◽  
Adult Population ◽  
Health Impacts ◽  
Regression Analyses ◽  
Pooled Prevalence ◽  
Anxiety Depression ◽  
Study Setting

The primary aim of this systematic review and meta-analysis was to examine the prevalence of technology-facilitated sexual violence (TFSV) within the adolescent and adult population regarding victimization and perpetration. In addition to the primary aim, associated health outcomes with TFSV were discussed through a qualitative lens. Specific forms of TFSV that were examined include distribution of, production of, and threats to distribute sexual material involving another individual without that person’s consent via images or videos; 425 articles from MEDLINE, PsycArticles, PsycINFO, Criminal Justice Abstracts, ProQuest Dissertations & Theses, and Google Scholar were screened. Nineteen articles (comprising 20 independent samples) reporting prevalence rates of TFSV on 32,247 participants were included in this random-effects meta-analysis. Pooled prevalence of victimization results revealed that 8.8% of people have had their image or video-based sexts shared without consent, 7.2% have been threatened with sext distribution, and 17.6% have had their image taken without permission. Regarding perpetration, 12% have shared sexts beyond the intended recipient, 2.7% have threatened to share sexts, and 8.9% have nonconsensually taken an image. Moderator variables included publication year, mean participant age, proportion of female participants, and study setting, with meta-regression analyses revealing no significant predictors. Finally, a qualitative analysis of nine articles ( n = 3,990) was conducted to assess mental health associations with TFSV victimization, revealing significant mental health impacts, including anxiety, depression, and poor coping, for victims.

Simultaneous compared to interval administration of mifepristone and misoprostol for medical abortion up to 10+0 weeks' gestation: a systematic review with meta-analyses

2020 ◽  
pp. bmjsrh-2019-200448
Author(s):  
Mia Schmidt-Hansen ◽  
Jonathan Lord ◽  
Elise Hasler ◽  
Sharon Cameron
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Medical Abortion ◽  
Cochrane Library ◽  
Published Data ◽  
Study Results ◽  
Randomised Controlled ◽  
Meta Analyses

BackgroundMedical abortion with mifepristone and misoprostol usually involves an interval of 36–48 hours between administering these drugs; however, it is possible that the clinical efficacy at early gestations may be maintained when the drugs are taken simultaneously. The objective of this systematic review was to determine the safety and effectiveness of simultaneous compared with interval administration of mifepristone and misoprostol for abortion up to 10+0 weeks’ gestation.MethodsWe searched Embase Classic, Embase; Ovid MEDLINE(R) including Daily, and Epub Ahead-of-Print, In-Process & Other Non-Indexed Citations; and Cochrane Library on 11 December 2019. We included randomised controlled trials (RCTs), published in English from 1985, comparing simultaneous to interval administration of mifepristone and misoprostol for early abortion. Risk of bias was assessed using the Cochrane Collaboration checklist for RCTs. Meta-analysis of risk ratios (RRs) using the Mantel-Haenszel method were performed. The quality of the evidence was assessed using GRADE.ResultsMeta-analyses of three RCTs (n=1280) showed no differences in ‘ongoing pregnancy’ (RR 1.78, 95% CI 0.38 to 8.36), ‘haemorrhage requiring transfusion or ≥500 mL blood loss’ (RR 0.11, 95% CI 0.01 to 2.03) and ‘incomplete abortion with the need for surgical intervention’ (RR 1.30, 95% CI 0.76 to 2.25) between the interventions. Individual study results showed no difference in patient satisfaction, or ‘need for repeat misoprostol’, although ‘time to onset of bleeding or cramping’ was longer after simultaneous than interval administration. The quality of evidence was very low to moderate.ConclusionThe published data support the use of simultaneous mifepristone and misoprostol for medical abortion up to 9+0 weeks in women who prefer this method of administration.

Does an association exist between menstrual cycle length within the normal range and ovarian reserve biomarkers during the reproductive years? A systematic review and meta-analysis

2020 ◽  
Vol 26 (6) ◽  
pp. 904-928 ◽  
Author(s):  
Johnny S Younis ◽  
Rula Iskander ◽  
Bart C J M Fauser ◽  
Ido Izhaki
Keyword(s):  
Systematic Review ◽  
Menstrual Cycle ◽  
Ovarian Reserve ◽  
Cycle Length ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Ivf Outcomes ◽  
Menstrual Cycle Length ◽  
Meta Analyses ◽  
Natural Cycles

Abstract BACKGROUND Regular menstrual cycling during the reproductive years is an indicator of spontaneous ovulation but sometimes falsely perceived as an indicator of preserved fertility. In contrast, menstrual cycle shortening, a physiologic occurrence preceding the menopausal transition, is not usually perceived as an indicator of decreased ovarian reserve in the general population. OBJECTIVE AND RATIONALE The individual decrease in menstrual cycle length (MCL) might represent a sensitive biomarker of diminishing ovarian reserve. The aim of this systematic review and meta-analysis is to examine the possible association between MCL in regularly cycling women (21–35 days) and ovarian reserve tests (ORT), fecundability in natural cycles and IVF outcomes. SEARCH METHODS An electronic database search employing PubMed, Web of Science, Trip, EBSCO, ClinicalTrials.gov and the Cochrane library was performed to identify research articles, only on human, published between January 1978 and August 2019. Search terms were pregnancy OR fertility OR fecundity OR fecundability, anti-Müllerian hormone OR AMH OR antral follicle count OR AFC OR ovarian reserve OR ovarian reserve test, in vitro fertilization OR ART OR assisted reproductive therapy OR assisted reproductive treatment OR assisted reproductive technology OR IVF OR ICSI, menstrual cycle length OR menstrual cycle characteristics. We combined these terms to complete the search. All prospective and retrospective studies exploring an association between MCL and proxies of ovarian reserve were included. The exclusions included studies of PCOS, ovarian failure, oral contraception treatment, prior chemotherapy and/or radiotherapy or ovarian surgery. The Newcastle–Ottawa scale was used to assess the quality of studies that were eligible for meta-analysis. OUTCOMES Eleven studies were eligible for meta-analysis, including 12 031 women. The included studies had a low risk of bias. Short MCL (21–27 days) was associated with lower ORT values as compared to normal (28–31 days), long (32–35 days) and all other (28–35 days) MCL sets. The estimated weighted mean difference (WMD) of AMH level was −1.3 ng/mL (95% CI: −1.75 to −0.86, P &lt; 0.001) between the short and normal MCL sets. The estimated WMD of AFC values was −5.17 (95% CI: −5.96 to −4.37, P &lt; 0.001) between the short and normal MCL sets. The weighted overall odds ratio (OR) of fecundability in natural cycles between women with short versus normal MCL sets was statistically significant (overall OR 0.81; 95% CI 0.72–0.91, P &lt; 0.001). In the IVF setting, fewer oocytes were retrieved in short MCL in comparison to normal, long and all other MCL sets, with an estimated WMD of −1.8 oocytes (95% CI: −2.5 to −1.1, P &lt; 0.001) in the short versus normal MCL sets. The weighted overall OR of clinical pregnancy rate between women with short versus all other MCL sets was statistically significant (overall OR 0.76; 95% CI: 0.60 to 0.96, P = 0.02). Low levels of heterogeneity were found in most meta-analyses of MCL and qualitative ovarian reserve biomarkers, while heterogeneity was high in meta-analyses performed for quantitative measures. WIDER IMPLICATIONS MCL in regularly cycling women is closely related to ovarian reserve biomarkers during the reproductive years. A short MCL, as compared to normal, is significantly associated with lower ORT values, reduced fecundability and inferior IVF outcomes, independent of age. The results imply that short MCL may be a sign of ovarian aging, combining the quantitative and qualitative facets of ovarian reserve. Educational efforts ought to be designed to guide women with short MCL at a young age, who desire children in the future, to seek professional counselling.

scholarly journals Prevalence of Exclusive Breastfeeding Practice and its Association with Maternal Employment in Ethiopia: A Systematic Review and Meta-Analysis, 2020

2020 ◽  
Author(s):  
GETU ENGIDA WAKE ◽  
YOHANNES MOGES MITTIKU
Keyword(s):  
Systematic Review ◽  
Exclusive Breastfeeding ◽  
Maternal Employment ◽  
Maternity Leave ◽  
Meta Analysis ◽  
Final Analysis ◽  
Cochrane Library ◽  
Pooled Prevalence ◽  
Ethiopian Government ◽  
Meta Analyses

Abstract Background: Exclusive breastfeeding is defined as the practice of providing only breast-milk for an infant for the first 6 months of life without addition of any other food or water, which recommends initiation of breastfeeding within one hour of life and continued breastfeeding for up to 2 years of age or more. There are highly variable findings regarding the prevalence of exclusive breastfeeding in Ethiopia. Maternal employment is the most important factor contributing to the low practice of exclusive breastfeeding. The purpose of this review was to estimate the pooled prevalence of exclusive breastfeeding and its association with maternal employment in the context of Ethiopia.Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used in this systematic review and meta-analysis. The databases such as; PubMed, Google Scholar, Science Direct, Cochrane library, Scopus, CINAHL, and Web of Science were systematically searched. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal. Results: Forty-five studies were included in the final analysis after reviewing 751 studies in this meta-analysis yielding the pooled prevalence of EBF 60.42% (95% CI: 55.81-65.02%) in Ethiopia. The subgroup analysis showed the highest prevalence reported in a study conducted in SNNP and Tigray( 87.84%), a study published during (2015-2016) (64.60 %), and among studies with a sample size of less than 500 (64.15%). Those employed mothers were 57% less likely to practice exclusive breastfeeding in comparison to unemployed mothers in Ethiopia [OR] 0.43; 95% CI (0.31, 0.61).Conclusions: Maternal employment was significantly associated with the practice of exclusive breastfeeding in comparison to their counterparts. The prevalence of exclusive breastfeeding in Ethiopia is low in comparison to the global recommendation. Based On our findings, we recommended that the Ethiopian government should increase legislated paid maternity leave after delivery beyond current paid maternity leave and implement policies that empower women and create a conducive environment for mothers to practice exclusive breastfeeding in the workplace.

scholarly journals Effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Weili Wang ◽  
Kuang-Huei Chen ◽  
Ying-Chieh Pan ◽  
Szu-Nian Yang ◽  
Yuan-Yu Chan
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Sleep Problems ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Control Group ◽  
Serious Adverse Events ◽  
Positive Effects ◽  
Meta Analyses

Abstract Objectives To examine the effectiveness and safety of yoga for women with sleep problems by performing a systematic review and meta-analysis.Methods Medline/PubMed, Clincalkey, ScienceDirect, Embase, PsycINFO, and the Cochrane Library were searched throughout the month of June 2019. Randomized controlled trials comparing yoga groups with control groups in women with sleep problems were included. Two reviewers independently evaluated risk of bias by using the risk of bias tool suggested by the Cochrane Collaboration for programming and conducting systematic reviews and meta-analyses. The main outcome measure was sleep quality or the severity of insomnia, which was measured using subjective instruments, such as the Pittsburgh Sleep Quality Index (PSQI), Insomnia severity index (ISI), or objective instruments, such as polysomnography, actigraphy, and safety of the intervention. For each outcome, standardized mean difference (SMD) and 95% confidence intervals (CIs) were determined. Results Nineteen studies including 1832 participants were included in this systematic review. Meta-analyses revealed positive effects of yoga using PSQI or ISI scores in 16 randomized control trials (RCTs) compared with the control group in improving sleep quality in women, PSQI (SMD = −0.54; 95% CI = −0.89 to −0.19 ; P = 0.003). However, three RCTs revealed no effects of yoga compared with the control group in reducing the severity of insomnia in women using ISI (SMD = −0.13; 95% CI = −0.74 to 0.48; P = 0.69). Seven RCTs revealed no evidence for effects of yoga compared with the control group in improving sleep quality for women with breast cancer using PSQI (SMD = −0.15 ; 95% CI = −0.31 to 0.01; P = 0.5). Four RCTs revealed no evidence for the effects of yoga compared with the control group in improving the sleep quality for peri-or postmenopausal women using PSQI (SMD = −0.31; 95% CI = −0.95 to 0.33; P = 0.34).Yoga was not associated with serious adverse events. Discussion This systematic review and meta-analysis found that yoga intervention in some groups of women was beneficial in managing sleep problems. Despite certain disadvantages in methodology in the included studies, yoga may be recommended as a complementary therapy to women.

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