这是用户在 2024-12-19 11:24 为 https://app.immersivetranslate.com/word/ 保存的双语快照页面,由 沉浸式翻译 提供双语支持。了解如何保存?

W

J

P

World Journal of
世界杂志

Psychiatry
精神病学

Submit a Manuscript: https://www.f6publishing.com World J Psychiatry 2022 April 19; 12(4): 636-650
提交手稿https://www.f6publishingcom世界精神病杂志 2022 年 4 月 19 日;12(4):636-650

DOI
数字对象标识符
: 10.5498/wjp.v12.i4.636 ISSN
国际标准刊号
2220-3206 (online
在线
)

Effects of mindfulness-based intervention programs on sleep among people with common mental disorders: A systematic review and
基于正念的干预计划对常见精神障碍患者睡眠的影响: 系统性研究和

meta-analysis
Meta 分析

Sunny Ho-Wan Chan, Danielle Lui, Hazel Chan, Kelly Sum, Ava Cheung, Hayley Yip, Chong Ho Yu
SunnyHo-Wan Chan,DanielleLui,Hazel Chan,Kelly Sum, Ava Cheung,Hayley Yip, ChongHo Yu

Specialty type: Psychiatry
专业类型: 精神病学

Provenance and peer review:
来源和同行评审:

Invited article; Externally peer reviewed.
特邀文章外部同行评审。

Peer-review model: Single blind
同行评议模式:单盲

Peer-review report’s scientific quality classification
同行评议报告的科学质量分类

Grade A (Excellent): 0
A 优秀):0

Grade B (Very good): 0
B 级很好): 0

Grade C (Good): C
C 良好):C

Grade D (Fair): 0
D 级合格):0

Grade E (Poor): 0
E 较差): 0

P-Reviewer: Kim Y, United States
P-审稿人: Kim Y, 美国

Received: February 24, 2021
收稿日期: 2021-02-24

Peer-review started: February 24, 2021
同行评审开始时间:2021 年 2 月 24 日

First decision: April 21, 2021
第一次决定:2021 年 4 月 2 日1 日

Revised: April 24, 2021
修订日期:2021 年 4 月 24

Accepted: March 14, 2022
录用日期: 2022-03-14

Article in press: March 14, 2022
新闻文章: March 14,2022

Published online: April 19, 2022
在线发布时间:2022 年 4 月 19 日

RESULTS
结果

We identified 397 articles, of which 10 randomised controlled trials, involving a total of 541 participants, were included in the meta-analysis. Studies of internet mindfulness meditation intervention (IMMI), mindfulness meditation (MM), mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction
我们确定了 397篇文章,其中10 项随机对照试验涉及541参与者,被纳入荟萃分析。互联网正念冥想干预研究(IMMI),正念冥想(MM),基于正念认知疗法MBCT),基于正念减压

WJP

https://www
万维网
.wjgnet.com 636 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

(MBSR) and mindfulness-based touch therapy (MBTT) met the inclusion criteria. The greatest effect sizes are reported in favour of MBTT, with SMDs of -1.138 (95%CI: -1.937 to -0.340; P = 0.005), followed by -1.003 (95%CI: -1.645 to -0.360; P = 0.002) for MBCT. SMDs of -0.618 (95%CI: - 0.980 to -0.257; P = 0.001) and -0.551 (95%CI: -0.842 to -0.260; P < 0.0001) were reported for IMMI and MBSR in the pooling trials, respectively. Significant effects on sleep problem improvement are shown in all reviewed MBI programs, except MM, for which the effect size was shown to be non- significant
(MBSR) 和基于正念的触摸疗法 (MBTT) 符合纳入标准。据报道,SMD 为 -1.138 的 MBTT 效应量最大(95% CI -1.937 至 -0.340;P = 0.005),然后是 -1.003(95% CI:-1.645 至 -0.360;P = 0.002),对于 -0.618 的 MBCTSMD (95% CI- 0.980 至 -0.257;P = 0.001)和 -0.551 (95% CI: -0.842 至 -0.260;在合并试验中分别报告了 IMMI 和 MBSR 的 P < 0.0001)。所有经过审查的 MBI 计划都显示了对睡眠问题改善的显着影响,但 MM 除外,其效应量被证明不显著
.

CONCLUSION
结论

All MBI programs (MBTT, MBCT, IMMI andMBSR), except MM, are effective options to improve sleep problems among people with depression or anxiety disorder.
MM,所有 MBI 计划(MBTT、MBCT、IMMI 和MBSR)都是改善抑郁症或焦虑症患者睡眠问题的有效选择

KeyWords: Mindfulness-based intervention programs; Common mental disorders; Sleep; Systematic review; Meta-analysis
关键词: 基于正念的干预 programs;常见的精神障碍;睡;系统评价;Meta 分析

©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
©作者 2022 年。BaishidengPublishing Group Inc. 出版 保留所有权利

Citation: Chan SHW, Lui D, Chan H, Sum K, Cheung A, Yip H, Yu CH. Effects of mindfulness-based intervention
引用:ChanSHW, Lui D, Chan H,Sum K, Cheung A, YipH,Yu CH.正念干预的效果

programs on sleep among people with common mental disorders: A systematic review and meta-analysis. World J Psychiatry 2022; 12(4): 636-650
常见精神障碍患者睡眠计划系统评价荟萃分析世界精神病杂志 2022;12(4):636-650

URL: https://www.wjgnet.com/2220-3206/full/v12/i4/636.htm
网址:https://www.wjgnet.com/2220-3206/full/v12/i4/636.htm

DOI: https://dx.doi.org/10.5498/wjp.v12.i4.636
DOI: https://dx.doi.org/10.5498/wjp.v12.i4.636

INTRODUCTION
介绍

Depression and anxiety disorder, also known as common mental disorders, are conditions that critically affect people’s emotions, energy and ability to function. Approximately 1 in 5 adults were identified as meeting criteria for a common mental disorder over the past 12 mo, with the lifetime prevalence reported as 20.8% and 28.8% for depression and anxiety disorder, respectively[1,2]. Both depression and anxiety disorder are among the top 10 causes of disease burden worldwide[3], prompting the necessity to find ways for better treatment and planning of care
抑郁症和焦虑症,也称为常见的精神障碍,是严重影响人们的情绪、精力和功能能力的疾病。在过去 12 个月中,大约每 5 名成年人中就有 1 名被确定为符合常见精神障碍的标准,据报道抑郁症和焦虑症的终生患病率分别为 20.8% 和 28.8%[12]。抑郁症和焦虑症都是全球疾病负担的 10 大原因之一[3],因此有必要寻找更好的治疗和护理规划方法
.

Insomnia frequently co-occurs with both depression[4] and anxiety disorder[5]. Sleep problems, which include difficulty in falling asleep, early awakening, poor sleep quality, daytime sleepiness and poor adherence to the sleep-wake cycle pattern, are particularly prevalent among people with depression and anxiety disorder[6]. The relationships between insomnia and common mental disorders appear to be bidirectional[7]. Symptoms of anxiety and depression, such as worry and rumination, can contribute to insomnia. Alternatively, insomnia can also increase the likelihood of developing depression or anxiety disorder, possibly due to the psychological distress as well as hormonal and neurochemical disturbances caused by poor sleep[8,9]. Thus, interventions aiming at reducing symptoms of insomnia should provide benefit for the disorder per se[10].
失眠经常抑郁症 [4] 焦虑症 [5] 同时发生。睡眠问题,包括入睡困难、醒、睡眠质量白天嗜睡睡眠-觉醒周期模式性差患有抑郁症和焦虑症[6]。失眠常见精神障碍之间的关系似乎是双向的[7]。焦虑抑郁的症状,忧愁反刍,都会导致失眠。或者,失眠也会增加抑郁症焦虑的可能性这可能是由于心理干扰以及荷尔蒙神经化学作用睡眠不佳引起的干扰[89]。 因此,旨在诱发失眠症状干预措施应该疾病本身提供益处[10]。

Individuals may consider psychotherapy instead of pharmaceutical treatment, due to possible side effects and potential dependence on medication[11-13]. Cognitive behavioural therapy (CBT) has been substantially confirmed to be an effective psychosocial treatment in managing depression and anxiety [14,15]. In a meta-analysis of 1205 CBT trials for anxiety disorders, results indicated that CBT for anxiety has a moderate effect on sleep[16]. In terms of the treatment of both depression and insomnia, another study found that the addition of CBT for insomnia (known as CBT-I) to antidepressant medication treatment can lead to better treatment outcomes [17]. However, some reviews showed that the effect sizes of CBT for depression have steadily decreased since its inception four decades ago [18,19]. Therefore, merely employing CBT might not be sufficient for managing mood disorders and their corresponding sleep problems.
由于可能的副作用和对药物的潜在依赖性,个体可能会考虑心理治疗而不是药物治疗[11-13]。认知行为疗法 (CBT) 已被基本证实是管理抑郁焦虑的有效社会心理治疗方法[1415]。 一项 1205 针对焦虑CBT试验荟萃分析中,结果表明CBT治疗焦虑睡眠中等影响[16]。 抑郁症失眠症的治疗方面另一项研究发现抗抑郁药物治疗加入治疗失眠的 CBT(称为CBT-I)可以带来更好的治疗结果[17]。 然而,一些综述表明CBT抑郁症疗效4年前开始以来一直在稳步下降[1819]。因此,仅使用CBT可能不足管理情绪障碍及其相应的睡眠问题。

Due to the limitations of traditional treatments, many people who experience insomnia are willing to consider using complementary and alternative medicine (CAM) as an alternative therapeutic option,
由于传统疗法的局限性,许多患者愿意考虑使用补充替代医学 (CAM) 作为替代治疗选择,

WJP

https://www
万维网
.wjgnet.com 637 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

including natural herbal products, acupuncture, or mind-body interventions, for example. A national health survey revealed that approximately 1.6 million adults in the United States have used CAM therapies to treat sleep problems[20]. Among different CAM therapies, the mind-body domains are by far the most commonly used[20]. Mindfulness-based interventions (MBIs), as a kind of CAM mind-body treatment with a focus on cultivating a sense of awareness, was originally developed to help people dealing with stress, anxiety, depression, or pain[21]. Mindfulness (Pali: sati) originated from Buddhism. As such, mindfulness can be defined as deliberately cultivating non-judgmental moment-to-moment awareness and experiences, through observing one’s own mind in a detached manner [22]. Various formal and informal mindfulness activities, such as body scan and sitting meditation, are included within the MBIs. Through these practices, the technique of ‘focusing on present moment’ can be acquired based on approach, compassion and decentring[23]. The inquiry process, which assists participants in identifying their thoughts, emotions and behaviours, is also included in these programs to help participants respond with more flexibility and awareness[24].
例如,包括天然草药产品、针灸或身心干预一项全国健康调查显示美国成年人中约有1.6使用 CAM疗法治疗睡眠问题[20]。在不同的CAM疗法中,身心疗法迄今为止最常用的[20]。 基于正念的干预 MBI作为一种专注于培养意识的 CAM身心治疗最初是为了帮助人们应对压力焦虑抑郁疼痛[21]。 正念Palisati起源佛教因此正念可以定义为刻意培养非评判性的每时每刻的意识体验,通过超然的方式观察一个人的own[22]。MBI 包括各种正式非正式心理活动,例如身体扫描着冥想。通过这些实践,可以获得基于方法、悲悯中心化的“专注于预先发送的时刻”的技术[23]。 探究过程,帮助参与者识别他们的想法、情绪行为,包含在这些计划中以帮助参与者以更灵活的方式回答意识[24]。

Conventional MBI has standardised protocols, and typically incorporates three formal mindfulness practices, namely body scan, mindful movement and sitting meditation[23]. A traditional program called mindfulness-based stress reduction (MBSR), kicking off the development of the mindfulness- based program in the health care domain, was first introduced by Kabat-Zinn[22]. It is an 8-wk program using mindfulness meditation (MM) and mindfulness practice in everyday life to relieve stress. Since then, another well-researched program — mindfulness-based cognitive therapy (MBCT) — was developed with comparable structures [25]. It is also an 8-wk program, which includes mindfulness practice and psychoeducation about depression, promoting awareness, acceptance and adaptive reaction towards negative automatic thoughts[25]. Apart from preventing relapse in depression, MBCT is also used to treat patients with psychiatric conditions, like anxiety disorders and post-traumatic stress disorder (PTSD)[26,27].
传统的 MBI 具有标准化的协议,通常包括三种正式正念练习,身体扫描、正念运动着冥想[23]。首先引入了一个名为基于正念的减压 (MBSR) 的额外计划该计划开始了医疗保健领域基于正念的计划的发展作者:Kabat-Zinn[22]。这是一个为期 8 的计划日常生活中使用正念冥想 (MM) 正念练习来缓解压力。从那时起另一个经过充分研究的项目——基于正念的认知疗法 (MBCT) ——被开发出来,具有类似的结构es[25]。 它也是一个8 周的计划,包括正念练习关于depression心理教育促进对消极自动想法的认识、接受适应性反应[25]。除了预防抑郁症复发外MBCT 用于治疗患有精神疾病的患者焦虑创伤应激障碍PTSD)[2627]。

Since the commencement of MBSR, various forms of mindfulness programs have evolved with different adaptations or modifications, such as the Mindfulness-Based Therapy for Insomnia (MBTI) [28], internet mindfulness meditation intervention (IMMI)[29], Mindfulness Awareness Program (MAP) [30], or mindfulness-based touch therapy (MBTT)[31]. Specifically, MBTI was developed for patients with insomnia. It integrates mindful meditation and behavioural therapy. By promoting awareness and adaptive response towards sleep disturbances, MBTI helps people with chronic insomnia with sleep restrictions and stimulus control[28]. IMMI was developed to offer mindfulness training anytime and anywhere by use of an Internet mode of delivery. IMMI includes six 1-h weekly sessions with 20 min of home-practice meditation between sessions [29]. MAP aims to teach participants principles of mindfulness, develop meditation practice and apply them in daily lives. MAP is mainly conducted in community settings, with a combination of lecture, hands-on practice, group feedback and discussion [30]. MBTT is an 8-wk program that combines components of MBSR and touch therapy. It was inspired by Ogden et al[32]’s model of hierarchical information processing, in which touch stimulus triggers sensorimotor reaction, which is then experienced as emotions and interpreted cognitively. Touch is believed to have healing effects on both the mind and body[31].
MBSR 开始以来,各种形式的正念课程已经发展起来,有不同的适应或修改例如基于正念失眠疗法 (MBTI)[28]、互联网正念冥想干预 IMMI)[29]、正念意识计划 MAP)[30] 或基于正念的触摸疗法 (MBTT)[31]。具体来说,MBTI是为失眠患者开发的。它整合了正念冥想和行为疗法。通过提高睡眠障碍的认识适应性反应MBTI帮助慢性失眠患者限制睡眠刺激控制[28]。IMMI 的开发旨在通过使用互联网交付方式随时随地提供正念训练IMMI包括每周 6 次1 小时的课程两次之间有 20分钟家庭练习冥想[29]。MAP旨在教授参与者正念的原则发展冥想练习并将其应用于日常生活MAP主要社区环境中进行,结合讲座、动手实践、小组反馈讨论[30]。 MBTT 是一个 8 的项目结合了MBSR触摸疗法组成部分,它的灵感来自 Ogden[32] 的模型分层信息处理,其中触摸刺激我们触发感觉运动反应,然后作为情绪体验认知解释触摸被认为身心都有治愈作用[31]。

At present, various studies have been published for the different MBIs. However, the review type studies usually focus on the conventional programs, like MBSR or MBCT [33,34]. While there are different forms of emerging MBIs in recent years, it is essential to have a comprehensive evaluation on their clinical effectiveness. Moreover, the traditional MBI programs have usually targeted general physical and psychiatric conditions; later on, they were used in the management of various kinds of physical or psychosomatic conditions, and even insomnia problems[35]. Recent meta-analyses indicated that MBIs show promising effects on the reduction of sleep problems[36-39]. However, these meta- analyses focused on the general population only or on people with physical comorbidities, such as cancer and fibromyalgia. Therefore, systematic review and meta-analysis on the effectiveness of the various MBI programs for sleep problems in individuals with depression or anxiety disorders is implied.
目前已经发表了针对不同MBI 的各种研究然而,综述类型的研究通常集中在常规项目MBSRMBCT[3334]。虽然近年来出现了不同形式的新兴 MBI但对其临床有效性进行全面评价至关重要。此外,传统的MBI计划通常具有针对一般身体精神状况;后来他们用于管理各种身体心身疾病甚至失眠问题[35]。 最近的荟萃分析表明MBIs减少睡眠问题方面显示出有希望的效果[36-39]。 然而,这些荟萃分析关注普通人群患有癌症纤维肌痛躯体合并症的人群因此,各种MBI计划抑郁焦虑个体睡眠问题的有效性进行系统评价荟萃分析暗示了 disorders

The objective of this meta-analysis was to determine and compare the clinical importance of different MBI programs on sleep problems among individuals with common mental disorders. Based on our research, this meta-analysis is uniquely able to fill a crucial gap in the field
本荟萃分析的目的是确定和比较不同 MBI 计划对常见精神障碍个体睡眠问题的临床重要性。根据我们的研究,这项荟萃分析独特地能够填补该领域的关键空白
.

MATERIALS AND METHODS
材料和方法

Literature search
文献检索

Literature searches were performed according to the 2009 PRISMA Statement for systematic reviews, by two independent researchers (Lui D and Chan H). The search keywords ofmindfulnessand mood or anxiety or depress*” and “sleep or insomnia” were used to ensure comprehensive coverage. Keyword searches were conducted in Embase, Medline (accessed through EBSCOhost), PubMed and PsycINFO (accessed through ProQuest) databases. Papers published between January 2010 and June 2020 were included. Publications were only restricted to English language and peer-reviewed.
根据 2009 年 PRISMA声明两名独立研究人员 LuiDChanH) 的系统评价进行文献检索使用正念情绪焦虑或抑郁*”和“睡眠或失眠”检索来确保全面覆盖。Embase、Medline通过EBSCOhost 访问)、PubMedPsycINFO通过ProQuest 访问)数据库中进行关键字搜索。包括 2010 年 1 月至 2020年 6 月期间发表论文。出版物仅限于英语,并经过同行评审。

WJP

https://www
万维网
.wjgnet.com 638 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

Study eligibility
研究资格

Titles and abstracts were screened, and full texts were selected for further review according to the following criteria. The inclusion criteria were as follows: (1) Experimental study with MBI; (2) Subjects selected for depression or anxiety disorder; (3) Sleep-related data taken at baseline and post- intervention; and (4) Randomised controlled trials (RCTs). The exclusion criteria were as follows: (1) Mixed intervention; or (2) Subjects with comorbidities other than depression or anxiety disorders. The selection criteria were confirmed according to the results of searching. The PRISMA flow diagram is shown in Figure 1
筛选标题和摘要,并根据以下标准选择全文进行进一步审查。纳入标准如下: (1) MBI 实验研究;(2) 选择抑郁症或焦虑症的受试者;(3) 在基线和干预后采集的睡眠相关数据;(4) 随机对照试验 (RCT)。排除标准如下: (1) 混合干预;或 (2) 患有抑郁症或焦虑症以外的合并症的受试者。根据检索结果确认纳入标准。PRISMA 流程图如图 1 所示
.

Data extraction
数据提取

An extraction form was used for each article to collect the following data: year of publication; subject setting; inclusion and exclusion criteria for participants; sample size for the experimental and control groups; participants’ age and sex; intervention given; and outcome measures related to sleep quality. Relevant statistics and effect sizes were also extracted, if available
每篇文章都使用提取表格来收集以下数据:出版年份;主题设置;参与者的纳入和排除标准;实验组和对照组的样本量;参与者的年龄和性别;给予干预;以及与睡眠质量相关的结果测量。如果可用,还提取了相关的统计数据和效应大小
.

Assessment on quality
质量评估

Two reviewers (Lui D andYip H), working independently, assessed the level of evidence (LoE) and appraisal stage for each of the articles using a standard quality assessment, namely the LoE [40] and revised cochrane risk-of-bias tool for randomised trials (RoB)[41] respectively. The LoE categorizes different experimental studies into different levels on a scale of I to V, with a smaller number indicating a higher LoE. The RoB was used to assess the risk of bias in the RCTs. A series of signalling questions were available in each of the five domains of assessment, and judgements were facilitated by an algorithm that maps responses to the signalling questions to a proposed judgement. Overall risk of bias of the individual study would be reported as “low risk of bias”, “some concerns” or “high risk of bias” . Disagreements between the two independent reviewers were resolved by a third reviewer through a consensus-based discussion
两名综述作者(Lui D 和 Yip H)独立工作,分别使用标准质量评估,即 LoE [40] 和修订的随机试验偏倚风险工具 (RoB)[41] [41],评估每篇文章的证据水平 (LoE) 和评价阶段。LoE 将不同的实验研究分为不同的级别,范围为 V 级,数字越小表示 LoE 越高。RoB 用于评估 RCT 的偏倚风险。在五个评估领域中,每个领域都有一系列信号问题,并且通过一种算法来促进判断,该算法将对信号问题的回答映射到建议的判断。单个研究的总体偏倚风险将报告为“低偏倚风险”、“一些担忧”或“高偏倚风险”。两位独立评价员之间的分歧由第三位评价员通过基于共识的讨论解决
.

Statistical analysis
统计分析

Statistical analysis of the pooled results was carried out using the Comprehensive Meta-Analysis software version 3.0 (https://www.meta-analysis.com). In nine of the ten studies, standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using post-intervention differences between the mean of mindfulness-based programs and the mean of controls, divided by the pooled standard deviation. No real differences in variability among studies were assumed according to the Cochrane Handbook for Systematic Reviews of Interventions[42]. A global estimation of r = 0.6 was, therefore, used as the correlation coefficient between post-treatment scores. In the remaining study, Cohen’s d was calculated using the two groups, via the one-way F-test using a practical meta-analysis effect size calculator[43]. When there was more than one group compared to the MBI group in the RCT, the non-intervention group was used as the control. The Q-statistic was used as the heterogeneity test, in which a statistically significant level of P < 0.05 indicated the variations in effect sizes were due to heterogeneity rather than sampling error. A random-effects model would be used when there was notable heterogeneity. Random-/fixed-effects models were used as the intervention effects are unlikely to be identical[44] given that there are significant variations in characteristics of each sample population. Publication bias was assessed by funnel plot, trim-and-fill and failsafe N. Unless otherwise specified, all statistical tests were two-sided with a significance level of 0.05.
使用ComprehensiveMeta-Analysis软件 3.0 https://www.meta-analysis.com版对合并结果进行统计分析 10 项研究中的 9 项研究中,使用基于正念的计划的平均值控件除合并的标准差。 根据 Cochrane干预系统评价手册 [42]假设研究之间的变异性没有真正的差异。因此,r=0.6全局估计用作治疗后评分之间的相关系数其余研究中,使用实用的荟萃分析效应计算器通过单向F 检验使用计算 Cohen 的d[43]。 RCTMBI相比止一组,非干预组被用作对照。采用Q 统计作为异质性检验,其中P<0.05统计学显著水平表明效应变异ns由于异质性而不是抽样误差。存在明显的异质性时将使用随机效应模型。 使用随机/固定效应模型干预效果不太可能相同[44]因为每个样本特征存在显著差异除非另有说明,否则所有统计检验均为显著性水平 0.05。

RESULTS
结果

Study selection
研究选择

A total of 808 entries were identified through database searches, and 397 of them were screened after duplicates removed. After reading the abstract and title of the remaining 397, we removed 25 reviews, case reports, and protocols. Full versions were retrieved for 372 papers, after which they were reviewed by two independent researchers (Chan H and Sum K) and disagreements were resolved by a third reviewer (Lui D) on a consensus-based discussion. In total, 362 full articles were excluded for not meeting all the inclusion criteria. Finally, 10 eligible studies were selected for systematic review and meta-analysis (details shown in Figure 1).
通过数据库检索共识别808条目其中 397个条目在去掉重复项后进行筛选。在阅读了其余397 篇的摘要标题后,我们删除了25综述、病例报告和方案。检索了 372 篇论文的完整版本,之后两名独立研究人员 (ChanHSumK) 审查第三审查员 (LuiD) 解决了分歧总共 362完整的文章不符合所有纳入标准而被排除在外。最后,选择了 10符合条件的研究进行系统评价荟萃分析详情如图 1 所示)。

Study characteristics
研究特征

Ten studies met the inclusion criteria, overall reporting five different kinds of mindfulness-based programs, including IMMI, MM, MBCT, MBSR and MBTT. Table 1 shows the study characteristics of the 10 trials. The studies were conducted in the United States, Germany, Norway, Australia and Austria, within years that fell between 2010 and 2019. A total of 541 participants were included in the intervention groups and comparison groups. When there were multiple intervention groups, we chose the mindfulness-based programs as the major intervention groups[45-47].
10项研究符合纳入标准,总体报告5种不同类型的静观项目包括IMMI、MM、MBCT、MBSRMBTT。 表 1显示了 10 试验的研究特征特性这些研究在美国德国挪威澳大利亚奥地利进行时间20102019 年不等。干预组和对照组纳入541参与者存在多个干预组时,我们选择基于正念的项目作为主要干预[45-47]。

WJP

https://www
万维网
.wjgnet.com 639 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

Ref. Country Sample
参考国家样本

Age
年龄

range (mean)
范围(平均值)

Women, n (%)
女性,n(%)

Randomisation
随机化

Intervention
介入

group

(comparison group)
(比较组)

Intervention duration
干预持续时间

Group size for effect
效果的组大小

size
大小

calculation,
计算

n

Outcome
结果

measure for sleep
睡眠测量

Wahbeh
瓦贝

United
联合

Older adult with
老年人

55-80

21 (81)
21(81)

R

IMMI

6 wk
6

I = 26 C = 24

20.00

Sleep disturbance
睡眠障碍
,

[29], 2018
29],2018

States
国家

depression symptoms
抑郁症状

(64.8)

(waitlist control)
(候补名单控制)

ISI

Boettcher
博特彻

Germany
德国

Community
社区

18+

34 (75.6)
34(75.6)

R

IMMI

8 wk
8

I = 45 C = 46

7.69

ISI

et al[50
等人50
],

dwellers with
居民

(37)

(discussion
讨论

2014

anxiety disorders
焦虑障碍

forum control group
论坛控制组
)

Wahbeh et

United
联合

Combat veterans
退伍军人

25-65 (I
25-65(一)

2 (7)
2(7)

R

MM (sitting
MM(坐着

6 wk
6

I = 27 C = 25

0

PSQI

al[47], 2016
AL47],2016

States
国家

with post-traumatic stress disorder
伴有创伤应激障碍

= 53.3; C =

53.0)

quietly
悄悄地
)

Britton et

United
联合

Antidepressant
抗抑郁药

24-61

21 (80.8)
21(80.8)

R

MBCT

8 wk
8

I = 14 C = 10

7.69

TIB, TST, SE, SOL
TIB、TST、SE、SOL
,

al[49], 2012
AL49],2012

States
国家

medication users with sleep
睡眠服药者

complaints
投诉

(47.0)

(control)
(控制)

WASO,TWT, Stage 1, SWS, Quality
WASO,TWT,阶段 1,SWS质量

llestad

Norway
挪威

Community
社区

18-65

26 (66.7)
26(66.7)

R

MBSR

8 wk
8

I = 39 C = 37

14

BIS

et al[51],
etal51],

dwellers with
居民

(42.5)

(waitlist
(候补名单

2011

anxiety disorders
焦虑障碍

control)
控制)

Britton et

United
联合

Community
社区

33-64

9 (69.2)
9(69.2)

R

MBCT

8 wk
8

I = 13 C = 8

19.23

TIB, TST, SE, SOL
TIB、TST、SE、SOL
,

al[48], 2010
AL48],2010

States
国家

dwellers with
居民

partially remitted depression
部分缓解的抑郁

(45.4)

(control)
(控制)

WASO, NWAK, Arousals, Stage 1, SWS, Quality
WASO、NWAK、唤醒、阶段 1、SWS质量

Hoge et al
Hoge

United
联合

Referral/community
推荐/社区

18+ (I =
18+(I=

23 (47.9)
23(47.9)

R

MBSR (stress
MBSR应力

8 wk
8

I = 48 C = 45

4.30

Sleep quality, PSQI
睡眠质量PSQI

[52], 2013
52],2013

States
国家

dwellers with
居民

generalized anxiety disorder
广泛性焦虑障碍

41; C = 37)
41 页;C= 37)

management education)
管理教育)

Horenstein
霍伦斯坦

United
联合

Adults with social
具有社交

18+

Not

R

MBSR

12 wk
12

I = 36 C = 36

15.28

Sleep quality, PSQI
睡眠质量PSQI

et al[45], 2019
et al45], 2019

States
国家

anxiety disorder
焦虑障碍

(32.7)

specified
指定

(control)
(控制)

Pinniger et

Australia
澳大利亚

Adults with self-
自我

18-68

10 (90.9)
10(90.9元)

R

MM (waitlist
MM候补名单

8 wk
8

I = 11 C = 23
我 =11C= 23

30.60

Sleeping
睡眠

al[46], 2013
AL46],2013

reported feelings of stress, anxiety
报告的压力感、焦虑感
,

and/or depression
和/或抑郁症

(39.5)

control)
控制)

difficulty/insomnia, ISI
困难/失眠,ISI

Stötter et al
Stötter

Austria
奥地利

Patients of the
患者的

18+ (I =
18+(I=

11

R

MBTT

8 wk
8

I = 14 C = 14

0

Sleep-onset
入睡

[31], 2013
31],2013

psychiatric hospital of Hall in Tirol
蒂罗尔霍尔精神病医院

42.8; C = 41.4)
42.8 页;C= 41.4)

(68.75)

(control)
(控制)

disorder, Sleep
disorder, 睡眠

maintenance
保养

disorders, Terminal sleep disorders,
疾病, 终末期睡眠障碍,

HDRS
HDRS (高动态范围)

Across studies, participants had a range of mean age between 32.7 and 64.8 years. Seven out of ten (70%) of the studies had a majority of female participants. Four out of ten studies (40%) focused on community dwellers with anxiety and/or major depressive disorder. One study included participants of veterans with PTSD. Six out of ten studies reported significant improvement in sleep quality as measured by insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI), Bergen insomnia scale (referred to as BIS), Hamilton depression rating scale (HDRS) and sleep diaries, provided that the P value of the experiment was lower than 0.05. All of the studies were RCTs. The duration of the intervention ranged from 6 wk to 12 wk and delivered over 6 to 12 sessions. Details of intervention techniques and selected outcome measures of each study are provided in Table 2
在研究中,参与者的平均年龄在 32.7 至 64.8 岁之间十分之七 (70%) 的研究中大多数是女性参与者十分之四的研究 (40%) 侧重于患有焦虑症和/或重度抑郁症的社区居民。一项研究包括患有 PTSD 的退伍军人的参与者。如果实验的 P 值低于 0.05,则 10 项研究中有 6 项报告了通过失眠严重程度指数 (ISI)、匹兹堡睡眠质量指数 (PSQI)、卑尔根失眠量表 (简称 BIS)、汉密尔顿抑郁量表 (HDRS) 和睡眠日记测量的睡眠质量显着改善。所有研究均为 RCT。干预持续时间从 6 周到 12 周不等,分 6 到 12 次进行。表 2 提供了每项研究的干预技术和选定结果测量的详细信息
.

WJP

https://www
万维网
.wjgnet.com 640 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

Intervention components
干预组成部分
Selecte
选择
d outcome
D 结果

measures for effect size Ref.
效应大小的测量 参考

program Intervention group Comparison group calculation
程序干预组比较组计算

IMMI

DI + MM + MPS

WL

ISI

Wahbeh[29], 2018
Wahbeh29],2018

ME + psychoeducation
ME + 心理教育

DF

ISI

Boettcher et al[50], 2014
Boettcher 等人502014

MM

BS

SB

PSQI

Wahbeh et al[47], 2016
Wahbeh 等人47],2016

BS

BS + SB

PSQI

Wahbeh et al[47], 2016
Wahbeh 等人47],2016

BS

SQ

PSQI

Wahbeh et al[47], 2016
Wahbeh 等人47],2016

BS + MB + MW + music meditation
BS + MB+ MW+ 音乐冥想

WL

ISI

Pinniger et al[46], 2013
Pinniger46],2013

MBCT

MA + HW (Guided audio CD
MA + HW 引导音频 CD
)

Control
控制

Sleep diary
睡眠日记

Britton et al[48], 2010
Britton 等人48],2010

MA (MB + MS + MW + lying + other simple movement) + HW (MM using audio CD + worksheet
MA MB + MS + MW + 躺着 + 其他简单动作)+ HW MM 使用音频 CD + 工作表
)

Control
控制

Sleep diary
睡眠日记

Britton et al[49], 2012
Britton 等人49],2012

MBSR

BS + SM + MB + AR + DI + ME + MMV + HW

WL

Bergen insomnia scale
卑尔根失眠量表

llestad et al[51], 2011
llestadetal51], 2011

BS+ BA+ gentle Hatha Yoga
BS+ BA+ 温柔哈达瑜伽

SME

PSQI

Hoge et al[52], 2013
Hoge52],2013

BS + SM + MS + MPS
理学学士 + 硕士 + 硕士 + 硕士

WL

PSQI

Horenstein et al[45], 2019
Horenstein 等人45],2019

MBTT

BA + touch + HW + counselling
BA + 触摸 + HW+ 咨询

BMT

HDRS

Stötter et al[31], 2013
Stötteretal31], 2013

Assessment of quality
质量评估

Results from quality assessments are presented in Tables 3 and 4. All studies were RCTs. All trials had adequate sequence generation, among which five (50%) indicated a concealed allocation[49-51]. As for blinding, two trials adopted double-blind design[48,49], one trial used single-blind design[31] and two used blind evaluators[47,52]. The drop-out rates of the trials ranged from 0% to 30.6%, as shown in Table 1. Of the 10 trials, 3 had low drop-out rates (≤ 5%)[31,47,52] and two had high drop-out rates (≥ 20%)[29,46]. The overall LoE was level II (n = 10), showing that the papers under current review were of high LoE. The overall RoBs were as follows: low (n = 2); some concerns (n = 6); and high (n = 2). The majority of papers showed some concerns of risk of bias, mainly due to bias in the measurement of outcome
质量评估结果见表 3 和 4所有研究均为 RCT。所有试验都有充分的序列生成,其中 5 项 (50%) 表明存在隐蔽分配 [49-51]。至于盲法,2 项试验采用双盲设计 [4849],1 项试验采用单盲设计 [31],2 项试验采用盲法评价器[4752]。试验的退出率从 0% 到 30.6% 不等,如 表 1 所示。在这 10 项试验中,3 项的退出率较低 (≤ 5%)[314752] 和 2 项的退出率较高 (≥ 20%)[2946]。总体 LoE 为 II 级 (n = 10),表明当前综述下的论文为高 LoE总体 RoB 如下低 (n = 2);一些担忧 (n = 6);和高 (n = 2)。大多数论文显示出一些偏倚风险的担忧,主要是由于结局测量中的偏倚
.

Analysis of overall effect
整体效果分析

This meta-analysis focused on examining the effect at the end point of different mindfulness-based programs, including IMMI, MM, MBCT, MBSR and MBTT, due to variations in follow-up periods and absence of reported follow-up effects in several studies. The overall effect analysed was based on the comparison between different mindfulness-based programs and comparison groups, including discussion forum, waitlist control, slow breathing, stress management education, sitting quietly and basic medicinal therapy. Self-rated outcome measurements were reported in the 10 RCTs assessed, including PSQI, ISI, sleep quality of sleep diary, and sleep maintenance of HDRS. The overall scores of sleep quality were reported in PSQI, ISI, BIS and sleep diaries. On the other hand, there was no overall score on sleep quality presented in HDRS. The component of sleep maintenance in HDRS was, therefore, selected. Sleep maintenance was selected instead of sleep onset and sleep termination, as the level of sleep maintenance better predicts perceived sleep quality[53]. Other outcome measurements which are not self-rated, including sleep onset latency, total sleep time and wake after sleep onset, were not reported in this meta-analysis
这项荟萃分析的重点是检查不同基于正念的计划(包括 IMMI、MM、MBCT、MBSR 和 MBTT)在终点的效果,因为几项研究的随访期不同且没有报告的随访效果。分析的总体效果基于不同基于正念的项目和比较组之间的比较,包括论坛、候补名单控制、缓慢呼吸、压力管理教育、安静坐着和基本药物治疗。在评估的 10 项 RCT 中报告了自评结局测量,包括 PSQI 、 ISI 、睡眠日记的睡眠质量和 HDRS 的睡眠维持。睡眠质量总分在 PSQI 、 ISI 、 BIS 和睡眠日记中报告。另一方面,HDRS 中没有关于睡眠质量的总体评分。因此,选择了 HDRS 中的睡眠维持组件。选择睡眠维持而不是入睡和终止睡眠,因为睡眠维持水平更好地预测感知到的睡眠质量 [53]。本荟萃分析未报告其他非自评结局指标,包括入睡潜伏期、总睡眠时间和入睡后觉醒
.

The mean effect sizes on sleep problem improvement of different mindfulness-based programs, as compared with control groups, are provided in Table 5. The forest plot in Figure 2 shows the effect sizes and 95%CIs of the 10 studies assessed. The meta-analysis reveals a moderate pooled effect size (g = - 0.527, 95%CI: -0.701 to -0.353) in favor of MBI program. Significant effects on sleep problem improvement were shown in four out of five of the different mindfulness-based programs under
5 提供了对照组相比不同基于正念的计划睡眠问题改善的平均效应大小2中的森林显示了评估95项研究效应量和10% CI荟萃分析显示适度的合并效应g =-0.527,95%CI:-0.701 -0。353)支持MBI计划。在五分之的不同基于正念的计划中,有 4显示出睡眠问题改善显着影响

https://www
万维网
.wjgnet.com 641 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

Ref.
裁判。
Research design
研究设计
Level of evidence
证据级别

Wahbeh[29], 2018 RCT, crossover design II
Wahbeh29], 2018 RCT交叉设计 II

Boettcher et al[50], 2014 RCT, crossover design II
Boettcher50,2014 年 RCT交叉设计 II

Wahbeh et al[47], 2016 RCT, multi-group pre-/post-test design II
Wahbehetal47], 2016 RCT/设计II

Britton et al[49], 2012 RCT, pre-/post-test control group design II
Britton49],2012 年 RCT测试/测试后对照组设计 II

llestad et al[51], 2011 RCT, crossover design II
llestadetal51], 2011 RCT交叉设计II

Britton et al[48], 2010 RCT, pre-/post-test control group design II
Britton48],2010 年 RCT测试/测试后对照组设计 II

Hoge et al[52], 2013 RCT, two group pre-/post-test design II
Hogeetal52], 2013 RCT/测试设计II

Horenstein et al[45], 2019 RCT, multi-group pre-/post-test design II
Horenstein45],2019 年 RCT/测试设计II

Pinniger et al[46], 2013 RCT, multi-group pre-/post-test design II
Pinnigeret al 46], 2013 RCT/测试设计II

Stötter et al[31], 2013 RCT, pre-/post-test control group design II
Stötteretal31],2013 年 RCT测试/测试后对照组设计II

Table 4 Risk of bias in the studies
表 4 研究中的偏倚风险

Ref.
裁判。

Randomisation process
随机化过程

Deviation from intended intervention
偏离预期干预

Missing
失踪

outcome data
结果数据

Measurement of outcome
结果测量

Selection of the reported results
选择报告结果

Overall
整体

Wahbeh[29], 2018
Wahbeh29],2018

Low risk
低风险

Low risk
低风险

Some concerns
一些担忧

Some concerns
一些担忧

Low risk
低风险

High

Boettcher et al
Boettcher 等人

Low risk
低风险

Low risk
低风险

Low risk
低风险

Some concerns
一些担忧

Low risk
低风险

Some
一些

[50], 2014
50],2014

concerns
关注

Wahbeh et al[47],
Wahbeh 等人47],

Low risk
低风险

Low risk
低风险

Low risk
低风险

Some concerns
一些担忧

Low risk
低风险

Some
一些

2016

concerns
关注

Britton et al[49],
Britton 等人49],

Low risk
低风险

Low risk
低风险

Low risk
低风险

Some concerns
一些担忧

Low risk
低风险

Some
一些

2012

concerns
关注

llestad et al

Low risk
低风险

Low risk
低风险

Low risk
低风险

Some concerns
一些担忧

Low risk
低风险

Some
一些

[51], 2011
51],2011

concerns
关注

Britton et al[48],
Britton 等人48],

Low risk
低风险

Some concerns
一些担忧

Low risk
低风险

Low risk
低风险

Low risk
低风险

Some
一些

2010

concerns
关注

Hoge et al[52], 2013
Hoge 等人52],2013

Low risk
低风险

Low risk
低风险

Low risk
低风险

Low risk
低风险

Low risk
低风险

Low

Horenstein et al
Horenstein 等人

Low risk
低风险

Low risk
低风险

Low risk
低风险

Some concerns
一些担忧

Low risk
低风险

Some
一些

[45], 2019
45],2019

concerns
关注

Pinniger et al[46], 2013
Pinniger 等人46],2013

Low risk
低风险

High risk
高风险

Some concerns
一些担忧

Low risk
低风险

Low risk
低风险

High

Stötter et al[31], 2013
Stötteretal31], 2013

Low risk
低风险

Low risk
低风险

Low risk
低风险

Low risk
低风险

Low risk
低风险

Low

review, namely MBTT, MBCT, IMMI and MBSR (reflecting descending order of effect sizes). The greatest effect sizes were reported in favour of MBTT, with SMDs of -1.138 (95%CI: -1.937 to -0.340; P = 0.005), followed by -1.003 (95%CI: -1.645 to -0.360; P = 0.002) for MBCT. SMDs of -0.618 (95%CI: -0.980 to -0.257; P = 0.001) and -0.551 (95%CI: -0.842 to -0.260; P < 0.0001) were reported for IMMI and MBSR in the pooling trials, respectively. However, among the five kinds of mindfulness-based programs under review, the mean effect size for MM on sleep was non-significant, with SMD of -0.264 (95%CI: -0.699 to 0.172; P = 0.236).
综述,MBTT、MBCT、IMMMBSR(反映效应大小的)。据报道有利于MBTT效应最大SMD -1.138(95% CI -1.937 -0.340;P= 0.005),然后是 -1.003(95% CI: -1.645 至 -0.360; P= 0.002) 的MBCT。SMD -0.618(95%CI:-0.980-0.257; P=0.001) -0.551(95%CI:-0.842 -0.260;P<0.0001) 在合并试验分别报告IMMIMBSR。然而,正在审查5基于正念d计划中MM睡眠的平均效应显著,SMD -0.264(95% CI-0.6990.172; P= 0.236)。

Heterogeneity test and publication bias
异质性检验发表偏倚

Table 5 shows that all the heterogeneities (Q) were non-significant across the different MBI programs. The non-significant Q-statistics might suggest that the variation in the effect sizes across the studies was simply due to low power but not the study characteristics. Three sets of asymmetry tests namely, funnel plots of precision, trim-and-fill and failsafe N — were used to estimate the publication bias in each study. Symmetrical distribution of the combined effect size revealed the absence of publication bias
表 5显示,我们在不同的MBI 计划中的所有异质性 Q都是不显著的。显著Q 统计量可能表明不同研究效应的变化仅仅是由于功效,而不是研究特性。使用不对称性测试——名称y、精度漏斗修剪和填充以及故障安全N——估计每项研究中的发表偏倚综合效应对称分布表明不存在发表偏倚

WJP

https://www
万维网
.wjgnet.com 642 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

Ref.
裁判。

Mindfulness-based program
基于正念的课程

k Subjects, n SMD (95%CI) P value
k个受试者,n 个 SMD (95%CI) P

Overall SMD (95%CI)
总体 SMD (95%CI)

Overall P value
总体 P

Q

Wahbeh[29], 2018
Wahbeh29],2018

Boettcher et al[50], 2014
Boettcher 等人502014

Wahbeh et al[47], 2016
Wahbeh et al 47],2016

Pinniger et al[46], 2013
Pinniger 等人46],2013

Britton et al[48], 2010
Britton 等人48],2010

Britton et al[49], 2012
Britton 等人49],2012

Hoge et al[52], 2013
Hoge52],2013

Horenstein et al
Horenstein 等人

[45], 2019
45],2019

llestad et al[51], 2011
llestadetal51],2011

IMMI

MM

MBCT

MBSR

2

2

2

3

124

86

43

187

-0.881 (-1.531 to - 0.231)
-0.881(-1.531 -0.231)

-0.500 (-0.935 to - 0.066)
-0.500(-0.935 至 -0.066)

-0.267 (-0.814 to 0.279)
-0.267(-0.814 至0.279)

-0.257 (-0.978 to 0.464)
-0.257(-0.978 至0.464)

-1.073 (-1.953 to - 0.192)
-1.073(-1.953 -0.192)

-0.923 (-1.862 to 0.016)
-0.923(-1.862 至0.016)

-0.449 (-0.942 to 0.043)
-0.449(-0.942 至0.043)

-0.555 (-1.056 to - 0.053)
-0.555(-1.056 至 -0.053)

-0.660 (-1.178 to - 0.141)
-0.660(-1.178 至 -0.141)

Stötter et al[31], MBTT
Stötteretal31], MBTT

1 28
128

-1.138 (-1.937 to -
-1.138(-1.937 -

2013

0.340)

0.008

0.024

0.337

0.485

0.017

0.054

0.074

0.03

0.013

0.005

-0.618 (-0.980 to - 0.257)
-0.618(-0.980 至 -0.257)

-0.264 (-0.699 to 0.172)
-0.264(-0.699 至0.172)

-1.003 (-1.645 to - 0.360)
-1.003(-1.645 至 - 0.360)

-0.551 (-0.842 to - 0.260)
-0.551(-0.842 至 -0.260)

-1.138 (-1.937 to - 0.340)
-1.138(-1.937 -0.340)

0.001

0.236

0.002

< 0.0001

0.005

0.912 (P = 0.34)
0.912P=0.34)

0.001 (P = 0.981)
0.001P=0.981)

0.052 (P = 0.82)
0.052P=0.82)

0.332 (P = 0.847)
0.332P=0.847)

0 (P = 1)
0P=1)

upon visual inspection of the funnel plots (Figure 3). To further examine the funnel plot symmetry, Duval and Tweedie’s trim-and-fill procedure was used. No significant adjustment was needed and no study was trimmed due to the absence of unmatched observations from the funnel plots. Failsafe N analyses demonstrated that 96 missing studies with a zero effect size have to be added to reduce the significant overall effect size to statistically non-significant levels
目视检查漏斗图(图 3)。为了进一步检查漏斗图对称性,使用了 Duval 和 Tweedie 的修剪和填充程序。由于漏斗图中没有不匹配的观测值,因此不需要进行重大调整,也没有修剪任何研究。Failsafe N 分析表明,必须添加 96 项效应量为零的缺失研究,才能将显著性总体效应量减少到统计学上不显著的水平
.

DISCUSSION
讨论

This meta-analysis showed that MBTT imparts the largest effect on sleep problems among the five different kinds of mindfulness-based programs under review, followed by MBCT, IMMI and MBSR. According to Cohen [54]’s thresholds for interpreting effect size, SMDs smaller than 0.20 would be regarded as small effect size, 0.50 as medium, 0.80 as large and 1.30 as very large. However, it is important to point out that Cohen defined the medium effect size based on his literature review using the Journal ofAbnormal and Social Psychology during the 1960s. These small, medium, and large effect sizes are, thus, specific to a particular domain (abnormal and social psychology) and as such these cut- off points should not be treated as absolute or universal. By Cohen’s convention, MBTT and MBCT have large effect sizes. IMMI and MBSR have medium effect sizes, and MM has a small effect size. It should be noted that, despite the large effect size of MBTT on sleep, only one study contributed to this result, while the results of the remaining four different kinds of mindfulness-based programs were supported by at least two or more studies. In addition, the effect of MM on sleep did not reach a significant level, despite having a small effect size. This may be explained by the unexplored improvements in sleep problems in the comparison group, leading to the comparatively non-significant effect of MM. Although previous findings suggested that MM is an effective treatment for insomnia [37], its effect on sleep for people with depression and anxiety disorder remains questionable, as shown in this meta-analysis.
这项荟萃分析显示所审查5不同类型的正念计划中,MBTT睡眠问题的影响最大其次MBCT、IMMIMBSR。根据Cohen[54] 解释效应大小的阈值小于0.20SMD将被视为效应量,0.50被视为中等,0.80被视为1.30非常大。然而,重要的是要指出Cohen根据他在 1960 年代使用 JournalofAbnormal and Social Psychology 的文献综述定义了中等效应量因此这些小、效应大小特定于特定领域(异常和社会心理学),因此不应将这些分界点视为绝对或普遍的。按照Cohen 的约定,MBTTMBCT 具有较大的效应量。IMMI 和MBSR具有中等有效量,MM具有较小的效应量。需要注意的是,尽管MBTT睡眠的影响很大,但只有一项研究这一结果有贡献而其余四种不同类型的结果基于正念的项目至少得到了两项或多项研究的支持此外,尽管 MM的效果较小睡眠的影响达到显著水平这可能是由于对照组睡眠问题得到探索改善导致效果相对显著的 MM尽管先前的发现表明MM治疗失眠的有效方法[37],但它抑郁症和焦虑症患者睡眠的影响仍然值得怀疑,如下所示元分析sis.

As such, MBTI has been commonly used to treat patients with chronic insomnia or sleep problems [35]. However, many studies involving MBTI [28,55] did not target people with depression or anxiety disorder, so MBTI was not selected in the current meta-analysis (according to the inclusion criteria). When further scrutinized, the goals of MBTI usually aim at promoting the adaptive response towards the emotional distress caused by sleep disturbances and daytime fatigue among people with chronic insomnia. However, the present review study revealed that those MBI programs which can improve sleep problems among people with depression or anxiety disorder may have additional characteristics. More specifically, those MBI programs under review were found to ameliorate both the mood and sleep
因此MBTI已被常用于治疗慢性失眠S leep问题患者[35]。然而,许多涉及MBTI 的研究[2855] 针对抑郁症焦虑患者因此MBTI被纳入目前的meta 分析(根据纳入标准)。当进一步审查d 时,MBTI 的目标通常旨在促进慢性患者睡眠障碍日间疲劳引起的情绪困扰适应性反应失眠。然而,综述显示那些可以改善抑郁症焦虑患者睡眠问题的MBI程序可能具有额外的特征。更具体地说,那些正在审查的 MBI 计划被发现可以改善情绪睡眠

WJP

https://www.wjgnet.com 643 April 19, 2022
Volume 12 I Issue 4
https://wwwwjgnetcom643 2022 年 4 月 19 12 卷第 4
I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

Figure 1 PRISMAflow diagram of the study.
1PRISM研究流程图

Figure 2 Forest plot of effect sizes. MBI: Mindfulness-based intervention; CI: Confidence interval.
图 2效应大小的森林图。 MBI: 正念基础干预;CI:置信区间。

problems concurrently. In other words, these MBI programs could target both the antecedents and consequences of sleep problems for people with common mental disorders
问题同时。换句话说,这些 MBI 计划可以针对患有常见精神障碍的人睡眠问题的前因和后果
.

MBTT [31] was found to have the largest effect on sleep problems, according to the meta-analysis. MBTT, which is based on mindfulness practice and various forms of massage and bodywork, could improve sleep by restoring interception and sensorimotor processing of individuals with depression and anxiety disorder. Regarding the effect of touch per se, the rhythmic and gentle massage produced a direct bodily and sensory experience[31]. This resulted in an antidepressant effect mediated by restoration of the impaired interoceptive functioning, which is associated with depression and anxiety [56,57], through stimulation of specific mechanoreceptors[58]. Adding to the independent effect of touch, a possible explanation for the synergistic effects of combining mindfulness practice and therapeutic touch is the model of hierarchical information processing, which suggested that mindfulness-based touch intervention gave rise to the integration of sensorimotor bodily experience
根据荟萃分析发现 MBTT[31]睡眠问题的影响最大MBTT 基于正念练习各种形式的massagebodywork,可以通过恢复个体的拦截和感觉运动处理来改善睡眠抑郁症和焦虑症。就触摸本身的效果而言有节奏轻柔按摩产生了直接的身体感官体验[31]。这导致了通过刺激特定的机械感受器[58]。除了触摸独立效果该模型还可能解释正念练习治疗性触摸相结合协同效应分层信息处理,这表明基于正念触摸交互导致了感觉运动身体体验的整合

WJP

https://www
万维网
.wjgnet.com 644 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

Figure 3 Funnel plot of standard error by standard difference in means.
图 3均值标准差值划分的标准误差漏斗

with mindful cognitive self-awareness [32]. In line with this explanation, a cortical plasticity model suggested that the sensory reorganization sprung from touch therapy was a mechanism for pain remediation[59]. Similarly, considering a previous study documenting the relationship between sensory processing and sleep quality[60], it is plausible that improving sensory processing through a mindfulness-orientated touch approach could, in turn, ameliorate sleep disturbance in people with depression or anxiety disorder.
具有正念认知自我意识[32]。这一解释一致皮质可塑性模型表明触摸疗法产生的感觉重组疼痛补救机制[59]。 同样考虑到之前一项记录感觉处理睡眠质量之间关系的研究[60],通过反过来,以正念为导向的触摸方法可以改善抑郁症或焦虑症患者的睡眠障碍

Besides, we also found that MBCT [48,49] can help improve sleep problems among people with depression or anxiety disorder, with large effect sizes. In addition to traditional mindfulness skills, MBCT incorporates cognitive behavioural skills which can enhance the effectiveness in coping with depressive mood and sleep problems. Despite the interrelated nature of depression and insomnia, it is theoretically debatable whether insomnia should be treated as a distinct diagnosis or a symptom of mood disorders[61]. Considering the complexity of insomnia, Shallcross et al[62] proposed a theoretical model to summarize the utility of MBCT in treating insomnia, suggesting that there are three treatment components (i.e., acceptance, attention control and experiential awareness) with different therapeutic functions across the integrated process model of insomnia. It is worth noting that the model of insomnia is in line with symptoms of people with depression. For example, rumination is associated with both depressive mood and sleep quality[63] and upregulated arousal is linked to sleep problems (e.g., longer sleep latency) in people with depressive syndromes[64,65]. The review studies suggested that MBCT can ameliorate the sleep disturbance of people who have achieved partial remission of depression (both with and without taking an anti-depressant) as well as significant mood improvement. It is possible that MBCT is not only a promising program for depression or insomnia alone, but also for improving sleep problems in people with depression. In addition, recent research has indicated that acceptance lessened the positive relation between awareness and sleep disturbance, with reduced stress level identified as a mediator[66]. This mechanism is consistent with the Monitor and Acceptance Theory[67], which proposes that awareness and acceptance may jointly improve emotional regulation, including that of stress. In this sense, the effectiveness of MBCT to reduce stress [68,69] can partially explain the potential utility of MBCT in improving sleep outcomes
此外,我们还发现 MBCT [4849] 可以帮助改善抑郁症或焦虑症患者的睡眠问题,效果较大。除了传统的正念技能外,MBCT 还结合了认知行为技能,可以提高应对抑郁情绪和睡眠问题的有效性。尽管抑郁和失眠具有相互关联的性质,但理论上应将失眠视为一种独特的诊断还是心境障碍的症状存在争议[61]。考虑到失眠的复杂性,Shallcross 等人[62] 提出了一个理论模型来总结 MBCT 在治疗失眠中的效用,表明在失眠的综合过程模型中,有三个治疗成分(即接受、注意力控制和体验意识)具有不同的治疗功能。值得注意的是,失眠的模型与抑郁症患者的症状一致。例如,反刍与抑郁情绪和睡眠质量相关[63],而觉醒上调与抑郁综合征患者的睡眠问题(例如更长的睡眠潜伏期)有关[6465]。综述研究表明,MBCT 可以改善已部分缓解抑郁症(服用和不服用抗抑郁药)的人的睡眠障碍,并显着改善情绪MBCT 可能不仅是一个有前途的计划,不仅单独治疗抑郁症或失眠症,而且还改善抑郁症患者的睡眠问题。此外,最近的研究表明,接受降低了意识与睡眠障碍之间的正相关关系,压力水平降低被认为是中介因素[66]。 这种机制与监控和接受理论[67]一致,该理论提出意识和接受可能共同改善情绪调节,包括压力调节。从这个意义上说,MBCT 减轻压力的有效性 [6869] 可以部分解释 MBCT 在改善睡眠结局方面的潜在效用
.

Therefore, solely utilizing MM [46,47] may not be robust enough to improve sleep problems among people with depression or anxiety disorder, as indicated by the insignificant effect size shown in this study. No wonder recent meta-analyses[70,71] supported that MM is effective in reducing symptoms such as rumination among people with depression or anxiety disorder, but the sleeping problem might be improved in the short-term only. As a bidirectional relationship has been revealed between sleep disturbance and common mental disorders[7], it seems that a more integrated approach should be considered in order to enhance robustness of the intervention effects. For instance, the addition of a touch approach[31], cognitive component[50] or health qigong[72] should help in promoting the effect- iveness of mindfulness practice, as applied in different clinical populations. Thus, the evolution of various kinds of integrated MBI programs should mark the necessity for meeting the increasing demand of various physical and mental health problems.
因此,仅使用MM[4647] 可能不足以改善抑郁症焦虑患者的睡眠质量这项研究难怪最近的荟萃分析[7071]支持MM有效减轻抑郁症焦虑患者的反刍等症状睡眠问题可能会得到改善只是短期的。由于睡眠障碍常见精神障碍之间存在双向关系[7],似乎应该考虑一种更综合的方法为了增强干预效果稳健性例如,添加触摸方法[31]、认知成分[50] 健康气功[72]应该有助于促进正念练习的效果适用于不同的临床人群。因此,各种综合 MBI 计划的发展应该标志着满足各种身心健康问题日益增长的需求的必要性。

Our analysis showed that the majority of studies were coded as having some concerns by RoB. Most concerns arise from measurement of outcome, as most sleep measurements, such as PSQI, ISI and sleep diary, rely on self-report by the patients. With the awareness of the treatment received, the non-blind allocation should lead to increased risk of bias. In addition, improvements in sleep cannot be merely assessed by objective tools like polysomnography but will also still rely on self-rated assessment tools. Thus, there is a possibility that some studies of good quality are not coded as low RoB due to the strict
我们的分析表明,大多数研究RoB 编码存在一些问题大多数担忧来自结果的测量因为大多数睡眠测量,例如PSQI、ISI睡眠日记,都依赖于患者的自我报告。在了解所接受的治疗的情况下,非盲分配导致偏倚风险增加此外,睡眠改善不能仅仅通过多导睡眠图等客观工具进行评估,但也依赖于自评评估工具。因此,由于 strict 的原因,一些高质量的研究可能没有编码RoB

WJP

https://www
万维网
.wjgnet.com 645 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

restrictions in outcome measurement tools, as stated in the RoB tool used in the current study. The studies included in this meta-analysis involved diverse sample populations in various age groups and with different emotional disorders, including mood disorders, anxiety disorders and PTSD. However, the heterogeneities were not significant, despite the variations in study characteristics. This may be explained by the high similarity in outcome measurement tools, among which PSQI, ISI and sleep diary were widely used to assess sleep outcome in the studies. Moreover, many of the studies under review had similar study protocols, and some were even conducted by the same group of researchers. The non- significance in heterogeneity may also be attributed to the low power of the studies. Nevertheless, moderator analysis can be considered in the future for possible effects of the potential moderators
结果测量工具的限制,如当前研究中使用的 RoB 工具中所述。本荟萃分析中包含的研究涉及不同年龄组的不同样本人群,并患有不同的情绪障碍,包括情绪障碍、焦虑障碍和 PTSD。然而,尽管研究特征存在差异,但异质性并不显著。这可能是由于结果测量工具的高度相似性来解释,其中 PSQI 、 ISI 和睡眠日记在研究中被广泛用于评估睡眠结果。此外,许多正在审查的研究具有相似的研究方案,有些甚至由同一组研究人员进行。异质性的不显著性也可能归因于研究的低功效。尽管如此,将来可以考虑对潜在调节剂的可能影响进行调节剂分析
.

Although the present meta-analysis suggests considerable clinical benefits of MBTT, MBCT, IMMI and MBSR on sleep among people with depression or anxiety disorder, the findings should be interpreted with caution. It should be noted that this meta-analysis has been primarily concerned with its limited power. A limited number of clinical trials on MBI programs are available in the literature databases, and many of the studies targeted populations with physical complications or other comorbidities. The result was that a relatively small number of trials met inclusion criteria. For example, there was only one study regarding MBTT that could be included. Thus, the effect of MBTT in our meta- analysis was solely determined by one study. The ability of funnel plot to detect publication bias was also restrained by the few number of trials included in our meta-analysis. Thus, there is a need to include larger clinical trials in the future to increase the study power. This analysis has concentrated on studying different kinds of MBI programs but not the specific components in the programs. It caused our study to have low generalizability compared to all the other protocols of the studied programs, because variations exist under the same program between different studies. For instance, gentle Hatha Yoga was included in one study of MBSR [52] but not in other trials[45,51]. Therefore, the effects of the MBI programs in this study are composed of various but nonspecific components. Further studies on specific intervention components, such as body scan, mindful walking, bodily awareness and mindful breathing are required. A further potential limitation of this review stems from the fact that the outcome measures of sleep focus on the subjective measurements only. The discrepancies in sleep measurement may have complicated the comparison. It is suggested that more objective and uniform measurement tools for sleep should be used in future studies in this field to facilitate a larger sample size and power in prospective systematic reviews and meta-analyses. For instance, polysomnography and electrocar- diogram use scientific technology to investigate some objective components of sleep and can be considered[49,73]. These could provide more objective evidence than self-rated scales. Lastly, the lack of Asian studies means that we cannot be certain that the findings can be generalized to an Asian population. Studies included in the current review were carried out only in the United States, Germany, Norway, Australia and Austria. More clinical trials in Asian countries are encouraged to increase generalizability of findings from future studies. It is also suggested that a more specific age group could be targeted to study the effect of MBIs on different age groups, like elderly and adolescent
尽管目前的荟萃分析表明 MBTT、MBCT、IMMI 和 MBSR 对抑郁症或焦虑症患者的睡眠有相当大的临床益处,但应谨慎解释这些发现。应该注意的是,这项荟萃分析主要关注其有限的功效。文献数据库中提供了数量有限的 MBI 计划的临床试验,其中许多研究针对患有身体并发症或其他合并症的人群。结果是相对较少的试验符合纳入标准例如,只有一项关于 MBTT 的研究可以纳入。因此,在我们的荟萃分析中,MBTT 的效果完全由一项研究决定。漏斗图检测发表偏倚的能力也受到我们荟萃分析中纳入的少量试验的限制。因此,未来需要纳入更大规模的临床试验,以提高研究能力。该分析侧重于研究不同类型的 MBI 程序,而不是程序中的特定组件。与所研究程序的所有其他方案相比,它导致我们的研究具有较低的泛化性,因为不同研究在同一程序下存在差异。例如,温和的哈达瑜伽被纳入一项 MBSR 研究 [52],但未包含在其他试验中 [4551]。因此,本研究中 MBI 程序的效果由各种但非特异性成分组成。需要对特定的干预组成部分进行进一步研究,例如身体扫描、正念行走、身体意识和正念呼吸。本综述的另一个潜在局限性源于睡眠的结局测量仅关注主观测量的事实。 睡眠测量的差异可能使比较复杂化。建议在该领域的未来研究中应使用更客观和统一的睡眠测量工具,以促进前瞻性系统评价和荟萃分析中更大的样本量和把握度。例如,多导睡眠图和心电图使用科学技术来研究睡眠的一些客观组成部分,可以考虑[4973]。这些量表可以提供比自评量表更客观的证据。最后,缺乏亚洲研究意味着我们不能确定这些发现是否可以推广到亚洲人群。本综述纳入的研究仅在美国、德国、挪威、澳大利亚和奥地利进行。鼓励在亚洲国家进行更多临床试验,以提高未来研究结果的普遍性。还建议可以针对更具体的年龄组来研究 MBI 对不同年龄组(如老年人和青少年)的影响
.

Despite these limitations, this review study adds to the literature by investigating different kinds of MBI programs on sleep problem among people with common mental disorders. The comprehensive inclusion and exclusion criteria contribute to the uniqueness of this meta-analysis. Studies that included subjects with comorbidities and with mixed intervention were excluded and, at the same time, a wide variety of MBI programs were included. The criteria allowed this meta-analysis to focus more on the effect of different MBI programs in order to fill in a lacuna in the research. Additionally, this meta- analysis has the following strengths. First, it followed the guidelines of the Cochrane Collaboration, which provided a standard process of analysis. The PRISMA Statement was also adopted to support the integrity of its systematic review process. Second, only RCTs were included in this analysis. All the studies analysed had high LoEs and most of them had low to moderate risk of bias. Bias is reduced by study design of adequate concealed allocation and blinding. The high quality of study design of the 10 included studies assured the reliability and validity of their results. Thus, this meta-analysis truly reflects the effect of different MBI programs. Third, all the studies analysed were conducted in the last decade. Since the first introduction of MBCT and MBSR by Kabat-Zinn [22], many innovative forms of MBI have been developed, as mentioned in the introduction. The clinical interest towards MBI has continued throughout the years. The meta-analysis in this paper included studies conducted in 2011- 2019, providing up-to-date information about the effect of different MBI programs on sleep among people with depression or anxiety disorders. The meta-analysis in this paper also focused on a specific client group and, as such, was able to provide an updated overview of comparison with traditional MBI and the newly developed programs.
尽管存在这些局限性,但这项综述研究通过调查不同种类MBI计划增加常见精神障碍患者睡眠问题综合纳入排除标准有助于荟萃分析的独特性包括患有合并症和混合干预的受试者的研究排除在外,并且在同时,包括各种各样的MBI程序这些标准都应该这项荟萃分析更多地关注不同MBI计划的效果填补研究中的空白此外,荟萃分析具有以下优点。首先,遵循Cochrane协作网指南该指南提供了标准的分析过程。 还采用了 PRISM A 声明来支持系统审查过程完整性其次,分析纳入RCT所有分析的研究都有高LoE,其中大多数研究都有中等偏倚风险通过充分隐藏分配和盲法的研究设计来减少偏倚纳入10 项研究高质量研究设计确保了结果可靠性和有效性因此,Meta分析真实地反映了不同MBI项目的效果。第三,所有分析的研究都是在过去十年进行的。 自从Kabat-Zinn [22] 首次引入 MBCTMBSR 以来,已经开发了许多创新形式的MBI引言中所述。多年来MBI临床兴趣一直持续本文荟萃分析包括2011-2019 年进行的d研究提供了有关不同MBI计划睡眠影响的最新信息在抑郁症或焦虑症患者中。本文中的荟萃分析针对特定的客户群体,因此能够提供与传统MBI 和新开发的程序的最新比较

CONCLUSION
结论

The findings of our comprehensive systematic review and meta-analysis provide preliminary evidence that MBTT, MBCT, IMMI and MBSR are effective options to improve sleep among people with depression and anxiety disorder. MM, which has confirmed to be effective in improving sleep in people with chronic insomnia, may not be effective in our targeted population. Taken together, these results
我们全面的系统评价荟萃分析的结果提供了初步证据,表明MBTT、MBCT、IMMIMBSR改善抑郁症和焦虑症患者睡眠的有效选择。已证实可有效改善慢性失眠症患者睡眠的 MM,但可能对我们的目标人群无效这些结果

WJP

https://www
万维网
.wjgnet.com 646 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

might provide a first step toward designing more integrated effective interventions for this specified clinical population who are suffering from sleep problems. We are hopeful that the findings of our research will inform health practitioners and other researchers on the extent of effectiveness of the different, latest and integrated MBI programs
可能为这个患有睡眠问题的特定临床人群设计更综合有效的治疗方法提供了第一步。我们希望我们的研究结果能够让健康从业者和其他研究人员了解不同、最新和综合的 MBI 计划的有效性程度
.

Research background
研究背景

Sleep problems are particularly prevalent in people with depression or anxiety disorder. Although mindfulness has been suggested as an important component in alleviating insomnia, no comprehensive review and meta-analysis has been conducted to evaluate the effects of different kinds of mindfulness- based intervention (MBI) programs on sleep among people with depression or anxiety disorder
睡眠问题在抑郁症或焦虑症患者中尤为普遍。尽管正念被认为是缓解失眠的重要组成部分,但尚未进行全面的审查和荟萃分析来评估不同类型的基于正念的干预 (MBI) 计划对抑郁症或焦虑症患者睡眠的影响
.

Research motivation
研究动机

The present study aimed to assess randomised controlled trials of various types of MBI programs for improving sleep problems in people with common mental disorders.
本研究旨在评估各种类型的MBI 计划用于改善常见精神障碍患者睡眠问题的随机对照试验

Research objectives
研究目标

The main objective was to evaluate and update evidence of effectiveness of the different, latest and integrated MBI programs.
主要目的是评估更新不同、最新综合 MBI 计划的有效性证据

Research methods
研究方法

We performed a systematic literature search on Embase, Medline, PubMed and PsycINFO databases from January 2010 to June 2020 for randomised controlled trials. Data were synthesized using a random- effects or a fixed-effects model to analyse the effects of various MBI programs on sleep problems among people with depression or anxiety disorder. The fixed-effects model was used when heterogeneity was negligible, and the random-effects model was used when heterogeneity was significant to calculate the standardised mean differences (SMDs) and 95% confidence intervals (CIs).
我们从 2010年1月至 20206Embase、Medline、PubMedPsycINFO数据库上进行了系统文献检索,以查找随机对照试验使用随机效应或固定效应模型综合数据,以分析各种MBI计划抑郁症或焦虑症患者睡眠问题的影响异质性可以忽略不计时,使用固定效应模型,当异质性w显著,使用随机效应模型计算标准化数差 SMD 95%置信区间 CI)。

Research results
研究成果

We identified 397 articles, of which 10 randomised controlled trials, involving a total of 541 participants, were included in the meta-analysis. Studies of internet mindfulness meditation intervention (IMMI), mindfulness meditation (MM), mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR) and mindfulness-based touch therapy (MBTT) met the inclusion criteria. The greatest effect sizes are reported in favour of MBTT, with SMDs of -1.138 (95%CI: -1.937 to -0.340; P = 0.005), followed by -1.003 (95%CI: -1.645 to -0.360; P = 0.002) for MBCT. SMDs of -0.618 (95%CI: -0.980 to -0.257; P = 0.001) and -0.551 (95%CI: -0.842 to -0.260; P = 0.000) were reported for IMMI and MBSR in the pooling trials,respectively. Significant effects on sleep problem improvement are shown in all reviewed MBI programs, except MM, in which its effect size was shown to be non-significant
我们确定了 397 篇文章,其中 10 项随机对照试验,共涉及 541 名参与者。互联网正念冥想干预 (IMMI)、正念冥想 (MM)、基于正念的认知疗法 (MBCT)、基于正念的减压 (MBSR) 和基于正念的触摸疗法 (MBTT) 的研究符合纳入标准据报道,SMD 为 -1.138 (95% CI-1.937 至 -0.340;P = 0.005),然后是 -1.003(95% CI:-1.645 至 -0.360;P = 0.002)。SMD 为 -0.618(95% CI:-0.980 至 -0.257;P = 0.001)和 -0.551 (95% CI -0.842 至 -0.260;P = 0.000) 在合并试验中分别报告了 IMMI 和 MBSR。除 MM 外,所有经过审查的 MBI 计划都显示了对睡眠问题改善的显着影响,其中其效应量被证明不显着
.

Research conclusions
研究结论

This review presents a comprehensive meta-analysis of various forms of MBI programs on helping sleep problems among people with common mental disorders. We found that all MBI programs (in terms of MBTT, MBCT, IMMI andMBSR), except MM, are effective options to improve sleep problems among people with depression or anxiety disorder.
这篇综述对各种形式的 MBI 计划进行了全面的 meta-a 分析,以帮助常见精神障碍患者的睡眠问题。我们发现除 MM 外,所有MBI项目 (MBTT、MBCT、IMMI和 MBSR) 都是改善抑郁症或焦虑症患者睡眠问题的有效选择

Research perspectives
研究视角

The current meta-analysis suggests that solely utilizing MM may not be robust enough to improve sleep problems among people with depression or anxiety disorder. As a bidirectional relationship was revealed between sleep disturbance and common mental disorders, it seems that a more integrated approach should be considered in order to enhance robustness of the intervention effects
目前的荟萃分析表明,仅使用 MM 可能不足以改善抑郁症或焦虑症患者的睡眠问题。由于揭示了睡眠障碍与常见精神障碍之间的双向关系,似乎应该考虑一种更综合的方法,以提高干预效果的稳健性
.

FOOTNOTES
脚注

Author contributions: Chan SHW conceived and guided the study; Lui D and Chan H carried out the literature
作者贡献:Chan SHW 构思并指导了这项研究;Lui DChanH进行了文献研究

searches; Chan H and Sum K extracted the data; Lui D andYip H assessed the study quality; Yu CH, Lui D and Sum K performed the statistical analyses; Chan SHW, Lui D, Cheung A and Yip H wrote and revised the paper
搜索;Chan H 和 Sum K 提取了数据;Lui D 和 Yip H 评估研究质量;Yu CH、Lui D 和 Sum K 进行统计分析;Chan SHW、Lui D、Cheung A 和 Yip H 撰写并修改了论文
.

Conflict-of-interest statement: The authors declare having no conflicts of interest.
利益冲突声明:作者声明 having 没有利益冲突。

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was
PRISMA 2009 检查表声明:作者已经阅读了 PRISMA 2009 检查表,手稿

WJP

https://www
万维网
.wjgnet.com 647 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

prepared and revised according to the PRISMA 2009 Checklist
根据 PRISMA 2009 检查表编制和修订
.

Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY- NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-
开放获取:本文是一篇开放获取的文章,由内部编辑选择,并外部审阅者完全进行同行评审它是根据CreativeCommonsAttributionNonCommercialCC BY- NC 4.0) 许可证分发的,许可证允许其他人分发重新混合改编商业性方式构建作品并以不同条款许可其衍生作品前提是正确引用原始作品使用-

commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ Country/Territory of origin: China
商业的。请参阅https://creativecommonsorg/Licenses/by-nc/4.0/Country/Territory of origin: China

ORCID number: Sunny Ho-Wan Chan 0000-0001-5136-8698; Danielle Lui 0000-0002-1441-9844; Hazel Chan 0000-0002- 0324-7100; Kelly Sum 0000-0003-1365-7784; Ava Cheung 0000-0001-6425-1915; Hayley Yip 0000-0002-3818-6934; Chong Ho Yu 0000-0003-2617-4853
ORCID 编号:Sunny Ho-Wan Chan 0000-0001-5136-8698;Danielle Lui 0000-0002-1441-9844;陈榛 0000-0002- 0324-7100;凯利·苏姆 0000-0003-1365-7784;张婉婷 0000-0001-6425-1915;叶海莉 0000-0002-3818-6934;张浩宇 0000-0003-2617-4853
.

S-Editor: Gao CC L-Editor: A
S-编辑: GaoCCL-编辑: A

P-Editor: Gao CC
P-编辑: GaoCC

REFERENCES
引用

1 Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 593-602 [PMID:
1 凯斯勒 RC、伯格伦德 P、德姆勒 O、金 R、梅里坎加斯 KR、沃尔特斯EE。全国合并症调查复制中 DSM-IV 疾病终生患病率发病年龄分布ArchGen 精神病学2005;62: 593-602[PMID:

15939837 DOI: 10.1001/archpsyc.62.6.593
15939837 DOI: 10.1001/archpsyc.62.6.593
]

2 Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D. The global prevalence of common mental
2 Steel Z, Marnane C, Iranpour C, CheyT,Jackson JW,Pate V,Silove D.常见精神的全球患病率

disorders: a systematic review and meta-analysis 1980-2013. IntJ Epidemiol 2014; 43: 476-493 [PMID: 24648481 DOI: 10.1093/ije/dyu038
疾病:1980-2013 年系统评价和荟萃分析。IntJ 流行病学 2014;43:476-493 [PMID:24648481 DOI:10.1093/ije/dyu038
]

3 Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry 2015; 72: 334-341 [PMID: 25671328 DOI:
3 Walker ER, McGee RE, Druss BG. 精神障碍死亡率全球疾病负担影响:系统评价和荟萃分析。 美国医学会精神病学 2015; 72:334-341PMID:25671328DOI:

10.1001/jamapsychiatry.2014.2502]

4 Peterson MJ, Rumble ME, Benca RM. Insomnia and psychiatric disorders. PsychiatrAnn 2008; 38: 597-605 [DOI: 10.3928/00485713-20080901-07
4 Peterson MJ, Rumble ME, Benca RM. 失眠和精神疾病。PsychiatrAnn 2008 年;38597-605 [DOI: 10.3928/00485713-20080901-07
]

5 Papadimitriou GN, Linkowski P. Sleep disturbance in anxiety disorders. Int Rev Psychiatry 2005; 17: 229-236 [PMID:
5 帕帕迪米特里欧 GN, 林科夫斯基 P.焦虑症中的睡眠障碍Int Rev 精神病学 2005;17: 229-236[PMID:

16194794 DOI: 10.1080/09540260500104524
16194794 DOI: 10.1080/09540260500104524
]

6 Soehner AM, Harvey AG. Prevalence and functional consequences of severe insomnia symptoms in mood and anxiety disorders: results from a nationally representative sample. Sleep 2012; 35: 1367-1375 [PMID: 23024435 DOI:
6 Soehner AM,Harvey AG。情绪焦虑障碍严重失眠症状的患病率和功能后果:来自全国代表性样本的结果。 Sleep 2012 年; 351367-1375[PMID: 23024435DOI:

10.5665/sleep.2116
10.5665/睡眠.2116
]

7 Fang H, Tu S, Sheng J, Shao A. Depression in sleep disturbance: A review on a bidirectional relationship, mechanisms and treatment. J Cell Mol Med 2019; 23: 2324-2332 [PMID: 30734486 DOI: 10.1111/jcmm.14170
7 Fang H, Tu S, Sheng J, Shao A. 睡眠障碍中的抑郁症:双向关系、机制和治疗综述。J Cell Mol Med 2019 年;23:2324-2332 [PMID:30734486 DOI:10.1111/jcmm.14170
]

8 Irwin MR. Why sleep is important for health: a psychoneuroimmunology perspective. Annu Rev Psychol 2015; 66: 143- 172 [PMID: 25061767 DOI: 10.1146/annurev-psych-010213-115205
8 欧文先生为什么睡眠对健康很重要:心理神经免疫学的观点。Annu Rev Psychol 2015;66143- 172 [PMID:25061767 DOI:10.1146/annurev-psych-010213-115205
]

9 Selsick H, O'regan D. Sleep disorders in psychiatry. BJPsych Adv 2018; 24: 273-283 [DOI: 10.1192/bja.2018.8
9 Selsick H, O'regan D. 精神病学中的睡眠障碍。BJPsych Adv 2018;24273-283 [DOI: 10.1192/bja.2018.8
]

10 Mason EC, Harvey AG. Insomnia before and after treatment for anxiety and depression. J Affect Disord 2014; 168: 415- 421 [PMID: 25108278 DOI: 10.1016/j.jad.2014.07.020
10 梅森 EC,哈维 AG。焦虑和抑郁治疗前后的失眠。J Affect Disord 2014 年;168:415- 421 [PMID:25108278 DOI:10.1016/j.jad.2014.07.020
]

11 Choy Y. Managing side effects of anxiolytics. Prim Psychiatry 2007; 14: 68-76
11 蔡 Y.管理抗焦虑药的副作用。Prim Psychiatry 2007 年;14:68-76

12 Starcevic V, Brakoulias V, Viswasam K, Berle D. Inconsistent portrayal of medication dependence, withdrawal and
12 Starcevic V, Brakoulias V, Viswasam K, Berle D. 药物依赖、戒断

discontinuation symptoms in treatment guidelines for anxiety disorders. Psychother Psychosom 2015; 84: 379-380 [PMID:
焦虑症治疗指南中的停药症状。 Psychother Psychosom 2015 年; 84379-380[PMID:

26402919 DOI: 10.1159/000439137
26402919 DOI: 10.1159/000439137
]

13 Telang S, Walton C, Olten B, Bloch MH. Meta-analysis: Second generation antidepressants and headache. J Affect Disord 2018; 236: 60-68 [PMID: 29715610 DOI: 10.1016/j.jad.2018.04.047
13 Telang S, Walton C, Olten B, Bloch MH.荟萃分析: 第二代抗抑郁药和头痛。J Affect Disord 2018 年;236:60-68 [PMID:29715610 DOI:10.1016/j.jad.2018.04.047
]

14 Twomey C, O'Reilly G, Byrne M. Effectiveness of cognitive behavioural therapy for anxiety and depression in primary care: a meta-analysis. Fam Pract 2015; 32: 3-15 [PMID: 25248976 DOI: 10.1093/fampra/cmu060
14 Twomey C, O'Reilly G, Byrne M. 初级保健中认知行为疗法对焦虑和抑郁的有效性:荟萃分析。Fam Pract 2015 年;32:3-15 [PMID:25248976 DOI:10.1093/fampra/cmu060
]

15 Zhang A, Borhneimer LA, Weaver A, Franklin C, Hai AH, Guz S, Shen L. Cognitive behavioral therapy for primary care
15 Zhang A, Borhneimer LA, Weaver A, Franklin C, Hai AH, GuzS,Shen L.初级保健的认知行为疗法

depression and anxiety: a secondary meta-analytic review using robust variance estimation in meta-regression. J Behav Med 2019; 42: 1117-1141 [PMID: 31004323 DOI: 10.1007/s10865-019-00046-z
抑郁和焦虑:在元回归中使用稳健方差估计的二级荟萃分析评价。J Behav Med 2019;421117-1141 [PMID: 31004323 DOI: 10.1007/s10865-019-00046-z
]

16 Belleville G, Cousineau H, Levrier K, St-Pierre-Delorme ME, Marchand A. The impact of cognitive-behavior therapy for anxiety disorders on concomitant sleep disturbances: a meta-analysis. J Anxiety Disord 2010; 24: 379-386 [PMID:
16 Belleville G, Cousineau H, Levrier K,St-Pierre-Delorme ME, March和 A.焦虑症认知行为疗法对伴随睡眠障碍的影响:荟萃分析。 JAnxiety Disord 2010;24: 379-386[PMID:

20369395 DOI: 10.1016/j.janxdis.2010.02.010
20369395 DOI: 10.1016/j.janxdis.2010.02.010
]

17 Manber R, Edinger JD, Gress JL, San Pedro-Salcedo MG, Kuo TF, Kalista T. Cognitive behavioral therapy for insomnia enhances depression outcome in patients with comorbid major depressive disorder and insomnia. Sleep 2008; 31: 489-495 [PMID: 18457236 DOI: 10.1093/sleep/31.4.489
17 Manber R, Edinger JD, Gress JL, San Pedro-Salcedo MG, Kuo TF, Kalista T. 失眠的认知行为疗法可改善共病重度抑郁症和失眠患者的抑郁结局。睡眠 2008;31489-495 [PMID:18457236 DOI:10.1093/sleep/31.4.489
]

18 Lynch D, Laws KR, McKenna PJ. Cognitive behavioural therapy for major psychiatric disorder: does it really work? Psychol Med 2010; 40: 9-24 [PMID: 19476688 DOI: 10.1017/S003329170900590X
18 林奇 D,劳斯 KR,麦肯纳 PJ。重度精神障碍的认知行为疗法:它真的有效吗?心理学医学 2010;40:9-24 [PMID:19476688 DOI:10.1017/S003329170900590X
]

19 Johnsen TJ, Friborg O. The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: A meta- analysis. Psychol Bull 2015; 141: 747-768 [PMID: 25961373 DOI: 10.1037/bul0000015
19 约翰森 TJ,弗里博格 O.认知行为疗法作为一种抗抑郁治疗的效果正在下降:荟萃分析。Psychol Bull 2015 年;141:747-768 [PMID:25961373 DOI:10.1037/bul0000015
]

20 Pearson NJ, Johnson LL, Nahin RL. Insomnia, trouble sleeping, and complementary and alternative medicine: Analysis of
20 皮尔逊 NJ,约翰逊 LL,纳欣 RL。失眠、睡眠困难以及补充替代药物icine:分析

WJP

https://www
万维网
.wjgnet.com 648 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

the 2002 national health interview survey data. Arch Intern Med 2006; 166: 1775-1782 [PMID: 16983058 DOI: 10.1001/archinte.166.16.1775
2002 年全国健康访谈调查数据。Arch 实习医学 2006;1661775-1782 [PMID: 16983058 DOI: 10.1001/archinte.166.16.1775
]

21 Kabat-Zinn J. Mindfulness-based interventions in context: Past, present, and future. Clin Psychol Sci Pract 2003; 10: 144-156 [DOI: 10.1093/clipsy.bpg016
21 Kabat-Zinn J. 上下文中基于正念的干预:过去、现在和未来。Clin Psychol Sci Pract 2003;10144-156 [DOI: 10.1093/clipsy.bpg016
]

22 Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delta Books, 1990
22 卡巴特-辛恩 J.完整的灾难生活:利用你的身心智慧来面对压力压力疾病。纽约:Delta Books,1990

23 Crane RS, Brewer J, Feldman C, Kabat-Zinn J, Santorelli S, Williams JM, Kuyken W. What defines mindfulness-based programs? Psychol Med 2017; 47: 990-999 [PMID: 28031068 DOI: 10.1017/S0033291716003317
23 克兰 RS、布鲁尔 J、费尔德曼 C、卡巴特-津 J、圣托雷利 S、威廉姆斯 JM、库伊肯 W。什么定义了基于正念的计划?心理学医学 2017;47:990-999 [PMID:28031068 DOI:10.1017/S0033291716003317
]

24 Baer R, Crane C, Miller E, Kuyken W. Doing no harm in mindfulness-based programs: Conceptual issues and empirical findings. Clin Psychol Rev 2019; 71: 101-114 [PMID: 30638824 DOI: 10.1016/j.cpr.2019.01.001
24 Baer R, Crane C, Miller E, Kuyken W. 在基于正念的计划中不造成伤害:概念问题和实证发现。临床心理学修订版 2019;71101-114 [PMID:30638824 DOI:10.1016/j.cpr.2019.01.001
]

25 Segal ZV, Williams JMG, Teasdale JD. Mindfulness-based cognitive therapy for depression. 2nd ed. New York: Guilford, 2013
25 西格尔 ZV,威廉姆斯 JMG,蒂斯代尔 JD。基于正念的抑郁症认知疗法第 2版。纽约:吉尔福德,2013

26 Ninomiya A, Sado M, Park S, FujisawaD, Kosugi T, Nakagawa A, Shirahase J, Mimura M. Effectiveness of mindfulness- based cognitive therapy in patients with anxiety disorders in secondary-care settings: A randomized controlled trial.
26 Ninomiya ASado M, Park S, FujisawaD, Kosugi T, Nakagawa A, ShirahaseJ,Mimura M.基于正念的认知疗法对二级护理环境中焦虑症患者的有效性 一项安定对照试验。

Psychiatry Clin Neurosci 2020; 74: 132-139 [PMID: 31774604 DOI: 10.1111/pcn.12960
精神病学临床神经科学 2020;74132-139 [PMID:31774604 DOI:10.1111/pcn.12960
]

27 Boyd JE, Lanius RA, McKinnon MC. Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence. J Psychiatry Neurosci 2018; 43: 7-25 [PMID: 29252162 DOI:
27 Boyd JE, Lanius RA, McKinnon MC. 基于正念的创伤后应激障碍治疗:治疗文献和神经生物学证据回顾J精神病学神经科学 2018;43: 7-25[PMID: 29252162DOI:

10.1503/jpn.170021
10.1503/日本170021
]

28 Ong JC, Manber R, Segal Z, Xia Y, Shapiro S, Wyatt JK. A randomized controlled trial of mindfulness meditation for chronic insomnia. Sleep 2014; 37: 1553-1563 [PMID: 25142566 DOI: 10.5665/sleep.4010
28 Ong JC、Manber R、Segal Z、Xia Y、Shapiro S、Wyatt JK。一项针对慢性失眠的正念冥想的随机对照试验。睡眠 2014;371553-1563 [PMID: 25142566 DOI: 10.5665/sleep.4010
]

29 Wahbeh H. Internet Mindfulness Meditation Intervention (IMMI) Improves Depression Symptoms in Older Adults. Medicines (Basel) 2018; 5 [PMID: 30400211 DOI: 10.3390/medicines5040119
29 Wahbeh H. 互联网正念冥想干预 (IMMI) 可改善老年人的抑郁症状。药品(巴塞尔),2018 年;5 [PMID:30400211 DOI:10.3390/medicines5040119
]

30 Klainin-Yobas P, Kowitlawakul Y, Lopez V, Tang CT, Hoek KE, Gan GL, Lei F, Rawtaer I, Mahendran R. The effects of mindfulness and health education programs on the emotional state and cognitive function of elderly individuals with mild cognitive impairment: A randomized controlled trial. J Clin Neurosci 2019; 68: 211-217 [PMID: 31303397 DOI:
30 Klainin-Yobas P, Kowitlawakul Y, Lopez V, Tang CT, Hoek KE,G anGL,Lei F,Rawtaer I,Mahendran R.正念和健康教育计划对轻度个体情绪状态和认知功能的影响认知障碍: 一项随机对照试验。J Clin Neurosci 2019; 68: 211-217[PMID: 31303397DOI:

10.1016/j.jocn.2019.05.031
图片:10.1016/j.jocn.2019.05.031
]

31 Stötter A, Mitsche M, Endler PC, Oleksy P, Kamenschek D, Mosgoeller W, Haring C. Mindfulness-based touch therapy and mindfulness practice in persons with moderate depression. Body Mov Dance Psychother 2013; 8: 183-198 [DOI:
31 Stötter A, Mitsche M, Endler PC, Oleksy P, Kamenschek D,Mosgoeller W,Haring C 中度抑郁症患者基于正念的触摸疗法和正念练习。 Body Mov Dance Psychother 2013 年; 8183-198[DOI:

10.1080/17432979.2013.803154]

32 Ogden P, Minton K, Pain C. Trauma and the body: A sensorimotor approach to psychotherapy. New York: W. W. Norton & Company, 2006
32 Ogden P, Minton K, Pain C. 创伤与身体:心理治疗的感觉运动方法。纽约:W.W. Norton& Company, 2006

33 Fjorback LO, Arendt M, Ornbøl E, Fink P, Walach H. Mindfulness-based stress reduction and mindfulness-based
33 Fjorback LO, Arendt M, Ornbøl E, Fink P, Walach H. 基于正念的压力减轻和基于正念

cognitive therapy: a systematic review of randomized controlled trials. Acta PsychiatrScand 2011; 124: 102-119 [PMID:
认知疗法: 随机对照试验的系统评价。Acta PsychiatrScand 2011;124102-119[PMID:

21534932 DOI: 10.1111/j.1600-0447.2011.01704.x
21534932 DOI: 10.1111/j.1600-0447.2011.01704.x
]

34 Querstret D, Morison L, Dickinson S, Cropley M, John M. Mindfulness-based stress reduction and mindfulness-based
34 奎斯特雷特 D, 莫里森 L, 迪金森S, 克罗普利 M, 约翰 M.正念 - 以减压和正念为基础

cognitive therapy for psychological health and well-being in nonclinical samples: A systematic review and meta-analysis. IntJ Stress Manag 2020; 27: 394-411 [DOI: 10.1037/str0000165
非临床样本中心理健康和福祉的认知疗法:系统评价和荟萃分析。IntJ 压力管理 2020;27:394-411 DOI:10.1037/str0000165
]

35 Ong J, Sholtes D. A mindfulness-based approach to the treatment of insomnia. J Clin Psychol 2010; 66: 1175-1184 [PMID: 20853441 DOI: 10.1002/jclp.20736
35 Ong J霍尔特斯 D.一种基于正念的失眠治疗方法。J Clin Psychol 2010 年;661175-1184 [PMID:20853441 DOI:10.1002/jclp.20736
]

36 Chen TL, Chang SC, Hsieh HF, Huang CY, Chuang JH, Wang HH. Effects of mindfulness-based stress reduction on sleep quality and mental health for insomnia patients: A meta-analysis. J Psychosom Res 2020; 135: 110144 [PMID: 32590218 DOI: 10.1016/j.jpsychores.2020.110144
36 Chen TL, Chang SC, Hsieh HF, Huang CY, Chuang JH, Wang HH.基于正念的减压对失眠患者睡眠质量和心理健康的影响:荟萃分析。J Psychosom 研究 2020;135110144 [PMID: 32590218 DOI: 10.1016/j.jpsychores.2020.110144
]

37 Gong H, Ni CX, Liu YZ, Zhang Y, Su WJ, Lian YJ, Peng W, Jiang CL. Mindfulness meditation for insomnia: A meta- analysis of randomized controlled trials. J Psychosom Res 2016; 89: 1-6 [PMID: 27663102 DOI:
37 龚 H, 倪 CX, 刘 YZ, 张 Y,苏 WJ, 连 YJ, PengW,CL.失眠正念冥想随机对照试验荟萃分析JPsychosom Res 2016 年; 891-6[PMID: 27663102DOI:

10.1016/j.jpsychores.2016.07.016]

38 Wang YY, Wang F, Zheng W, Zhang L, Ng CH,Ungvari GS, Xiang YT. Mindfulness-Based Interventions for Insomnia: A Meta-Analysis of Randomized Controlled Trials. Behav Sleep Med 2020; 18: 1-9 [PMID: 30380915 DOI:
38 王 YY, 王 F, 郑 W, 张 L, Ng CH,Ungvari GS, Xiang YT.基于正念的失眠干预:随机对照试验的荟萃分析Behav Sleep Med 2020 年;181-9[PMID: 30380915DOI:

10.1080/15402002.2018.1518228]

39 Zhang J, Xu R, Wang B, Wang J. Effects of mindfulness-based therapy for patients with breast cancer: A systematic review and meta-analysis. Complement Ther Med 2016; 26: 1-10 [PMID: 27261975 DOI: 10.1016/j.ctim.2016.02.012
39 Zhang J, Xu R, Wang B, Wang J. 基于正念的疗法对乳腺癌患者的影响:系统评价和荟萃分析。补充 Ther Med 2016;261-10 [PMID:27261975 DOI:10.1016/j.ctim.2016.02.012
]

40 Howick J, Chalmers I, Glasziou P, Greenhalgh T, Heneghan C, Liberati A, Moschetti I, Phillips B, Thornton H, Goddard O, Hodgkinson M. The Oxford 2011 levels of Evidence: Oxford Centre for Evidence-Based Medicine, 2011
40 Howick J, Chalmers I, Glasziou P, Greenhalgh T,Heneghan C,Li berati A,Moschetti I,PhillipsB,Thornton H,Goddard O, Hodgkinson M.牛津 2011 年证据水平:牛津循证医学中心 (Oxford Centre for Evidence-BasedMedicine),2011

41 Higgins JPT, Savović J, Page MJ, Elbers RG, Sterne JAC. Assessing risk of bias in a randomized trial. In: Higgins JPT, Thomas J, Chandler J, CumpstonM, Li T, Page MJ, Welch VA. Cochrane Handbook for Systematic Reviews of
41 希金斯 JPTSavović J,佩奇 MJ,埃尔伯斯 RG,斯特恩 JAC。评估偏风险 n一项随机试验。在:HigginsJPT, ThomasJChandlerJCumpstonMLiTPageMJWelchVACochrane系统评价手册

Interventions version 60: Cochrane, 2019
干预版本 60:Cochrane,2019

42 Higgins JPT, Li T, Deeks JJ. Choosing effect measures and computing estimates of effect. In: Higgins JPT, Thomas J,
42 Higgins JPT, Li T, Deeks JJ. 选择效果度量计算效果刺激In:HigginsJPT,Thomas J,

Chandler J, CumpstonM, Li T, Page MJ, Welch VA. Cochrane Handbook for Systematic Reviews of Interventions version 60: Cochrane, 2019
钱德勒J坎普斯顿 MT佩奇MJ韦尔奇VA。 Cochrane干预性系统评价手册60 版:Cochrane,2019

43 Lipsey MW, Wilson DB. Practical meta-analysis. Thousand Oaks: Sage Publications, 2009
43 利普西 MW,威尔逊 DB。实用荟萃分析。千橡市:Sage Publications,2009

44 Deeks JJ, Higgins JPT, Altman DG. Analysing data and undertaking meta-analyses. In: Higgins JPT, Thomas J, Chandler J, CumpstonM, Li T, Page MJ, Welch VA. Cochrane Handbook for Systematic Reviews of Interventions version 60:
44 迪克斯 JJ,希金斯 JPT,阿尔特曼 DG。分析数据并进行荟萃分析。In:HigginsJPT,Thomas J,Chandler J, CumpstonM, Li T, PageMJWelchVA. Cochrane干预性系统综述手册60 版:

Cochrane, 2019
科克伦,2019

45 Horenstein A, Morrison AS, Goldin P, Ten Brink M, Gross JJ, Heimberg RG. Sleep quality and treatment of social anxiety disorder. Anxiety Stress Coping 2019; 32: 387-398 [PMID: 31082285 DOI: 10.1080/10615806.2019.1617854
45 Horenstein A, Morrison AS, Goldin P, Ten Brink M, Gross JJ, Heimberg RG.睡眠质量和社交焦虑症的治疗。焦虑压力应对 2019;32:387-398 [PMID:31082285 DOI:10.1080/10615806.2019.1617854
]

46 Pinniger R, Thorsteinsson EB, Brown RF, Mckinley P. Tango dance can reduce distress and insomnia in people with self- referred affective symptoms. Am J Dance Ther 2013; 35: 60-77 [DOI: 10.1007/s10465-012-9141-y
46 Pinniger R, Thorsteinsson EB, Brown RF, Mckinley P. 探戈舞可以减少有自我指涉情感症状的人的痛苦和失眠。Am J Dance Ther 2013 年;35: 60-77 [DOI: 10.1007/s10465-012-9141-y
]

47 Wahbeh H, Goodrich E, GoyE, Oken BS. Mechanistic Pathways of Mindfulness Meditation in Combat Veterans With Posttraumatic Stress Disorder. J Clin Psychol 2016; 72: 365-383 [PMID: 26797725 DOI: 10.1002/jclp.22255
47 Wahbeh H, Goodrich E, GoyE, Oken BS. 患有创伤后应激障碍的退伍军人正念冥想的机制途径。J Clin Psychol 2016;72:365-383 [PMID:26797725 DOI:10.1002/jclp.22255
]

48 Britton WB, Haynes PL, Fridel KW, Bootzin RR. Polysomnographic and subjective profiles of sleep continuity before and
48 布里顿 WB、海恩斯 PL、弗里德尔 KW、布津 RR。睡眠相关性的多导睡眠图和主观概况

WJP

https://www
万维网
.wjgnet.com 649 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Chan SHW et al. Meta-analysis of MBI programs on sleep
ChanSHW人。 MBI计划睡眠荟萃分析

after mindfulness-based cognitive therapy in partially remitted depression. PsychosomMed 2010; 72: 539-548 [PMID:
在部分缓解的抑郁症中接受基于正念的认知疗法后。 PsychosomMed 2010 年; 72: 539-548[PMID:

20467003 DOI: 10.1097/PSY.0b013e3181dc1bad
20467003 DOI: 10.1097/PSY.0b013e3181dc1bad
]

49 Britton WB, Haynes PL, Fridel KW, Bootzin RR. Mindfulness-based cognitive therapy improves polysomnographic and subjective sleep profiles in antidepressant users with sleep complaints. Psychother Psychosom 2012; 81: 296-304 [PMID:
49 布里顿 WB,海恩斯 PL,弗里德尔 KW,布津 RR。基于正念的认知疗法改善了有睡眠问题的抗抑郁药使用者的睡眠图主观睡眠概况。Psychother Psychosom 2012 年; 81: 296-304[PMID:

22832540 DOI: 10.1159/000332755
22832540 DOI: 10.1159/000332755
]

50 Boettcher J, Aström V, Påhlsson D, Schenström O, Andersson G, Carlbring P. Internet-based mindfulness treatment for anxiety disorders: a randomized controlled trial. Behav Ther 2014; 45: 241-253 [PMID: 24491199 DOI:
50 Boettcher J, Aström V, Påhlsson D,Schenström O, Andersson G, CarlbringP.基于互联网的焦虑症正念治疗:一项随机对照试验。 行为Ther 2014; 45: 241-253[PMID: 24491199DOI:

10.1016/j.beth.2013.11.003]

51 Vøllestad J, Sivertsen B,Nielsen GH. Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial. BehavRes Ther 2011; 49: 281-288 [PMID: 21320700 DOI: 10.1016/j.brat.2011.01.007
51 Vøllestad JSivertsen B,Nielsen GH.焦虑症患者基于正念的减压:随机对照试验中的评估。BehavRes Ther 2011 年;49:281-288 [PMID:21320700 DOI:10.1016/j.brat.2011.01.007
]

52 Hoge EA, Bui E, Marques L, Metcalf CA, Morris LK, Robinaugh DJ, Worthington JJ, Pollack MH, Simon NM.
52 Hoge EA, Bui E, Marques L, MetcalfCA, Morris LK, Robinaugh DJ,Worthington JJ,Pollack MH,Simon NM.

Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. J Clin Psychiatry 2013; 74: 786-792 [PMID: 23541163 DOI: 10.4088/JCP.12m08083
正念冥想治疗广泛性焦虑症的随机对照试验:对焦虑和压力反应性的影响。J 临床精神病学 2013;74:786-792 [PMID:23541163 DOI:10.4088/JCP.12m08083
]

53 Libman E, Fichten C, Creti L, Conrod K, Tran DL, Grad R, Jorgensen M, Amsel R, Rizzo D, Baltzan M, Pavilanis A, Bailes S. Refreshing Sleep and Sleep Continuity Determine Perceived Sleep Quality. Sleep Disord 2016; 2016: 7170610 [PMID: 27413553 DOI: 10.1155/2016/7170610
53 Libman E, Fichten C, Creti L, Conrod K, Tran DL, Grad R, Jorgensen M, Amsel R, Rizzo D, Baltzan M, Pavilanis A, Bailes S. 清爽的睡眠和睡眠连续性决定了感知的睡眠质量。睡眠障碍 2016;2016 年:7170610 [PMID:27413553 DOI:10.1155/2016/7170610
]

54 Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates Inc., 1988
54 科恩 J.行为科学的统计功效分析s.2nd ed.HillsdaleLawrenceErlbaum AssociatesInc.,1988

55 Goldstein MR, Turner AD, Dawson SC, Segal ZV, Shapiro SL, Wyatt JK, Manber R, Sholtes D, Ong JC. Increased high- frequency NREM EEG power associated with mindfulness-based interventions for chronic insomnia: Preliminary findings from spectral analysis. J Psychosom Res 2019; 120: 12-19 [PMID: 30929703 DOI: 10.1016/j.jpsychores.2019.02.012
55 Goldstein MR、Turner AD、Dawson SC、Segal ZV、Shapiro SL、Wyatt JK、Manber R、Sholtes D、Ong JC。与基于正念的慢性失眠干预相关的高频 NREM 脑电图功率增加:频谱分析的初步结果。J Psychosom 研究 2019;12012-19 [PMID: 30929703 DOI: 10.1016/j.jpsychores.2019.02.012
]

56 Dunn BD, Stefanovitch I, Evans D, Oliver C, Hawkins A, Dalgleish T. Can you feel the beat? BehavRes Ther 2010; 48: 1133-1138 [PMID: 20692645 DOI: 10.1016/j.brat.2010.07.006
56 邓恩 BDStefanovitch I, 埃文斯 D, 奥利弗 C, 霍金斯 A, 达格利什 T.你能感觉到节拍吗?BehavRes Ther 2010 年;481133-1138 [PMID: 20692645 DOI: 10.1016/j.brat.2010.07.006
]

57 Harshaw C. Interoceptive dysfunction: toward an integrated framework for understanding somatic and affective disturbance in depression. Psychol Bull 2015; 141: 311-363 [PMID: 25365763 DOI: 10.1037/a0038101
57 Harshaw C. 内感受功能障碍:迈向理解抑郁症躯体和情感障碍的综合框架。Psychol Bull 2015 年;141:311-363 [PMID:25365763 DOI:10.1037/a0038101
]

58 Eggart M, Queri S, Müller-Oerlinghausen B. Are the antidepressive effects of massage therapy mediated by restoration of impaired interoceptive functioning? Med Hypotheses 2019; 128: 28-32 [PMID: 31203905 DOI:
58 Eggart M, QueriS, Müller-Oerlinghausen B.按摩疗法的抗抑郁作用是由感受功能受损恢复介导的吗?医学假说 2019;128: 28-32[PMID: 31203905DOI:

10.1016/j.mehy.2019.05.004]

59 Casals-Gutierrez S, Abbey H. Interoception, mindfulness and touch: A meta-review of functional MRI studies. IntJ Osteopath Med 2020; 35: 22-33 [DOI: 10.1016/j.ijosm.2019.10.006
59 CasalsGutierrez S, Abbey H. 内感受、正念和触摸:功能性 MRI 研究的元回顾。IntJ 整骨医学 2020;35:22-33 [DOI:10.1016/j.ijosm.2019.10.006
]

60 Engel-Yeger B, Shochat T. The relationship between sensory processing patterns and sleep quality in healthy adults. Can J Occup Ther 2012; 79: 134-141 [PMID: 22822690 DOI: 10.2182/cjot.2012.79.3.2
60 恩格尔-叶格尔 BShochat T.健康成人感觉处理模式与睡眠质量之间的关系。Can J Occup Ther 2012;79134-141 [PMID:22822690 DOI:10.2182/cjot.2012.79.3.2
]

61 Harvey AG. Insomnia: symptom or diagnosis? Clin Psychol Rev 2001; 21: 1037-1059 [PMID: 11584515 DOI: 10.1016/s0272-7358(00)00083-0
61 哈维 AG。失眠:症状还是诊断?Clin Psychol Rev 2001;211037-1059 [PMID: 11584515 DOI: 10.1016/s0272-7358(00)00083-0
]

62 Shallcross AJ, Visvanathan PD, Sperber SH, Duberstein ZT. Waking up to the problem of sleep: can mindfulness help? Curr Opin Psychol 2019; 28: 37-41 [PMID: 30390479 DOI: 10.1016/j.copsyc.2018.10.005
62 Shallcross AJ、Visvanathan PD、Sperber SH、Duberstein ZT。醒来发现睡眠问题:正念有帮助吗?Curr Opin Psychol 2019;28:37-41 [PMID:30390479 DOI:10.1016/j.copsyc.2018.10.005
]

63 Slavish DC, Graham-Engeland JE. Rumination mediates the relationships between depressed mood and both sleep quality and self-reported health in young adults. J Behav Med 2015; 38: 204-213 [PMID: 25195078 DOI:
63 斯拉夫 DC,格雷厄姆-恩格兰 JE。反刍介导了年轻人抑郁情绪睡眠质量和自我报告的健康状况之间的关系。 JBehav Med 2015 年; 38: 204-213[PMID: 25195078DOI:

10.1007/s10865-014-9595-0]

64 Surova G, Ulke C, Schmidt FM, Hensch T, Sander C, Hegerl U. Fatigue and brain arousal in patients with major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2021; 271: 527-536 [PMID: 33275166 DOI:
64 Surova G, Ulke C,Schmidt FM, Hensch T,Sander C,Hegerl U.度抑郁症患者的疲劳和大脑唤醒欧洲拱门精神病学临床神经科学 2021;271: 527-536[PMID: 33275166DOI:

10.1007/s00406-020-01216-w]

65 Ulke C, Sander C, Jawinski P, MaucheN, Huang J, SpadaJ, Wittekind D, Mergl R, Luck T, Riedel-Heller S, Hensch T, Hegerl U. Sleep disturbances and upregulation of brain arousal during daytime in depressed vs non-depressed elderly
65 Ulke CSander C, Jawinski P, MaucheN, Huang J,SpadaJ, Wittekind D, MerglR,Luck T,Riedel-Heller S,HenschT, Hegerl U.抑郁老年人与n老年人白天睡眠障碍和大脑觉醒上调

subjects. World J Biol Psychiatry 2017; 18: 633-640 [PMID: 27557150 DOI: 10.1080/15622975.2016.1224924
科目。世界生物学精神病学杂志 2017;18:633-640 [PMID:27557150 DOI:10.1080/15622975.2016.1224924
]

66 Lau WKW, Leung MK, Wing YK, Lee TMC. Potential Mechanisms of Mindfulness in Improving Sleep and Distress. Mindfulness (NY) 2018; 9: 547-555 [PMID: 29599851 DOI: 10.1007/s12671-017-0796-9
66 刘 WKW, 梁 MK, 永 YK, 李 TMC.正念 n 改善睡眠和痛苦的潜在机制。正念 (纽约) 2018;9:547-555 [PMID:29599851 DOI:10.1007/s12671-017-0796-9
]

67 Lindsay EK, Creswell JD. Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT). Clin Psychol Rev 2017; 51: 48-59 [PMID: 27835764 DOI: 10.1016/j.cpr.2016.10.011
67 林赛 EK,克雷斯韦尔 JD。正念训练的机制:监控和接受理论 (MAT)。临床心理学修订版 2017;51:48-59 [PMID:27835764 DOI:10.1016/j.cpr.2016.10.011
]

68 Foley E, Baillie A, Huxter M, Price M, Sinclair E. Mindfulness-based cognitive therapy for individuals whose lives have been affected by cancer: a randomized controlled trial. J Consult Clin Psychol 2010; 78: 72-79 [PMID: 20099952 DOI: 10.1037/a0017566
68 Foley E, Baillie A, Huxter M, Price M, Sinclair E. 针对生活受癌症影响的个体的基于正念的认知疗法:一项随机对照试验。J Consult Clin Psychol 2010;78:72-79 [PMID:20099952 DOI:10.1037/a0017566
]

69 van Son J, NyklícekI, Pop VJ, Blonk MC, Erdtsieck RJ, Spooren PF, Toorians AW, Pouwer F. The effects of a
69 vanSonJNyklcekIPopVJBlonkMC Erdtsieck RJ, Spooren PF,Toorians AW,PouwerF.效果

mindfulness-based intervention on emotional distress, quality of life, and HbA(1c) in outpatients with diabetes (DiaMind): a randomized controlled trial. Diabetes Care 2013; 36: 823-830 [PMID: 23193218 DOI: 10.2337/dc12-1477
基于正念的糖尿病门诊患者情绪困扰、生活质量和 HbA (1c) 干预 (DiaMind):一项随机对照试验。糖尿病护理 2013;36823-830 [PMID:23193218 DOI:10.2337/dc12-1477
]

70 Reangsing C, Rittiwong T, Schneider JK. Effects of mindfulness meditation interventions on depression in older adults: A meta-analysis. Aging Ment Health 2021; 25: 1181-1190 [PMID: 32666805 DOI: 10.1080/13607863.2020.1793901
70 Reangsing C, Rittiwong T, 施耐德 JK.正念冥想干预对老年人抑郁症的影响:荟萃分析。老龄化心理健康 2021;251181-1190 [PMID: 32666805 DOI: 10.1080/13607863.2020.1793901
]

71 Ren Z, Zhang Y, Jiang G. Effectiveness of mindfulness meditation in intervention for anxiety: A meta-analysis. Acta Psychologica Sinica 2018; 50: 283-305 [DOI: 10.3724/SP.J.1041.2018.00283
71 任 Z, 张 Y, 江 G. 正念冥想干预焦虑的有效性:荟萃分析。心理学杂志 2018;50:283-305 [DOI:10.3724/SP.电话: J.1041.2018.00283
]

72 Chan SHW, Chan WWK, Chao JYW, Chan PKL. A randomized controlled trial on the comparative effectiveness of
72 Chan SHW, Chan WWK, Chao JYW,Chan PKL.关于比较有效性随机对照里亚尔

mindfulness-based cognitive therapy and health qigong-based cognitive therapy among Chinese people with depression and anxiety disorders. BMC Psychiatry 2020; 20: 590 [PMID: 33317481 DOI: 10.1186/s12888-020-02994-2
中国抑郁症和焦虑症患者的基于正念的认知疗法和基于健康气功的认知疗法。BMC 精神病学 2020;20:590 [PMID:33317481 DOI:10.1186/s12888-020-02994-2
]

73 Smith JH, Baumert M, Nalivaiko E,McEvoy RD, Catcheside PG. Arousal in obstructive sleep apnoea patients is
73 Smith JH, Baumert M, Nalivaiko E,McEvoy RD, Catcheside PG.阻塞性睡眠呼吸暂停患者的觉醒

associated with ECG RR and QT interval shortening and PR interval lengthening. J Sleep Res 2009; 18: 188-195 [PMID:
与 ECG RR 和 QT 间期缩短以及PRRVAL延长相关。 JSleep Res 2009;18188-195[PMID:

19645965 DOI: 10.1111/j.1365-2869.2008.00720.x
19645965 DOI: 10.1111/j.1365-2869.2008.00720.x
]

WJP

https://www
万维网
.wjgnet.com 650 April
四月
19, 2022
Volume
12 I Issue
问题
4 I

Published by Baishideng Publishing Group Inc
Baishideng Publishing Group Inc 出版

7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
7041 KollCenter Parkway, Suite160, 普莱森顿,CA94566, 美国

Telephone: +1-925-3991568
电话:+1-925-3991568

E-mail: bpgoffice@wjgnet.com
电子邮件: bpgoffice@wjgnet.com

Help Desk: https://www.f6publishing.com/helpdesk
帮助https://www.f6publishingcom/帮助台

https://www.wjgnet.com