Cultural adaptations likely improve the effectiveness of psychological interventions for sleep disorders. These findings, from a systematic review, were published in Sleep Medicine Reviews.<\/p>\n
Researchers from Columbia University searched publication databases for randomized clinical trials of psychological interventions for sleep disorders conducted in the United States. A total of 56 studies were included in the final analysis.<\/p>\n
These studies comprised an average sample size of 85.23 (range, 11-219) individuals in the intervention and 38.40 (range, 5-91) individuals in the control arms. The vast majority had 2-arm trial designs (91.07%) lasting an average of 7.69 weeks (range, 2 weeks to 2 years).<\/p>\n
These studies were dominated by participants who were women (mean, 55.35%; standard deviation [SD], 43.22%) and White (mean, 64.86%; SD, 21.67%) and only 6.97% focused on underserved populations.<\/p>\n
Participants had definitive diagnoses of a sleep disorder in 32 studies, 9 studies included individuals with probable sleep disturbance, and 15 with potential sleep disturbance. Among studies of patients with an established diagnosis, 75% studied insomnia, 9.38% nightmares with poor sleep quality, 6.25% poor sleep quality, 3.12% restless leg syndrome, 3.12% nocturia, and 3.12% nightmares with insomnia.<\/p>\n
The primary outcome was sleep quality (n=40), insomnia (n=30), sleep efficiency (n=21), sleep duration (n=21), nightmares (n=8), and drowsiness (n=4).<\/p>\n
The most studied interventions were cognitive behavioral therapy for insomnia (CBT-I; n=20), complementary and alternative medicine (n=8), and behavioral therapy (n=7), cognitive behavioral therapy (n=4), among others.<\/p>\n
These interventions were tailored to their study populations by either surface- and\/or deep-level cultural adaptations (64.29%). CBT-I was most commonly adapted (38.89%). Surface-level adaptations included changes to the delivery modality, setting, dosing, constituent-involving strategies, and linguistic changes. Deep-level adaptations were content-level, core component, sociocultural, and linguistic changes.<\/p>\n
The studies with a cultural adaptation component generally found insomnia was significantly improved compared with pharmacotherapy, but few found changes in nightmares, sleep efficiency, or sleep duration.<\/p>\n
Participants who received CBT-I with surface- or deep-level cultural adaptation (n=11 studies) had significantly improved symptoms of insomnia compared with various control groups, usual care, hygiene education, or healthy eating educations. A subset of these studies also reported improvements to sleep efficiency (n=6) and sleep quality (n=7).<\/p>\n
Few studies of surface- or deep-level cultural adaptations for interventions of probable or possible sleep disturbances found significant improvements to sleep.<\/p>\n
These findings were limited by the underlying study populations which lacked diversity.<\/p>\n
The study authors concluded that interventions for established sleep disorders which have been culturally tailored for the population were more successful than control conditions or usual care.<\/p>\n
Reference<\/p>\n
Alcntara C, Cosenzo LG, McCullough E, Vogt T, Falzon AL, Ibarra IP. Cultural adaptations of psychological interventions for prevalent sleep disorders and sleep disturbances: A systematic review of randomized controlled trials in the United States. Sleep Med Rev. 2021;101455. doi:10.1016\/j.smrv.2021.101455<\/p>\n
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Psychological Interventions With Cultural Adaptations More Effective for Treatment of Sleep Disorders - Psychiatry Advisor<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Cultural adaptations likely improve the effectiveness of psychological interventions for sleep disorders. Continue reading