BACKGROUND/PURPOSE:Sleep plays an important role in individuals' health. The functions of the brain, the cardiovascular system, the immune system, and the metabolic system are closely associated with sleep. As a prevalent sleep disorder, insomnia has been closely concerned, and it is necessary to find effective therapies. In recent years, a growing body of studies has shown that mind-body therapies (MBTs) can improve sleep quality and ameliorate insomnia severity. However, a comprehensive and overall systematic review has not been conducted. In order to examine the effect of MBTs on insomnia, we conducted a systematic review and meta-analysis evaluating the effects of MBTs on sleep quality in healthy adults and clinical populations.

METHODS:PubMed, EMBASE, the Cochrane Library, and review of references were searched up to July 2018. English language studies of all designs evaluating the effect of MBTs on sleep outcomes in adults with or without diseases were examined. To calculate the SMDs and 95% CIs, we used a fixed effect model when heterogeneity was negligible and a random effect model when heterogeneity was significant.

RESULTS:49 studies covering 4506 participants published between 2004 and 2018 were identified. Interventions included meditation, tai chi, qigong, and yoga which lasted 4 to 24 weeks. The MBTs resulted in statistically significant improvement in sleep quality and reduction on insomnia severity but no significant effects on sleep quantity indices, which were measured by sleep diary or objective measures. We analyzed the effects of tai chi and qigong separately as two different MBTs for the first time and found that qigong had a slight advantage over tai chi in the improvement of sleep quality. Subgroup analyses revealed that the effect of MBTs on sleep quality in healthy individuals was larger than clinical populations. The effect of MBTs might be influenced by the intervention duration but not the frequency.

CONCLUSIONS:MBTs can be effective in treating insomnia and improving sleep quality for healthy individuals and clinical patients. More high-quality and well-controlled RCTs are needed to make a better conclusion in further study.

The purpose of this study was to observe and compare the clinical efficacy of active acupuncture and placebo acupuncture in the treatment of insomnia and mood disorders. 96 patients with insomnia in Chengdu were randomly divided into two groups (1:1). The active acupuncture group (AA group n = 48) received the tube of Park sham device with deep needle insertion. The placebo acupuncture group (PA group n = 48) received the tube of Park sham device with a retractable needle shaft and a blunt tip. The same acupuncture points and treatment cycles were used in both groups. The overall scorefor the Pittsburgh Sleep Quality Index (PSQI) is the primary outcome. Secondary outcomes recorded sleep rate, self-reported depression scale (SDS), self-assessment anxiety scale (SAS), the 'six component' scores of PSQI, andscale scores. Eventually, 90 patients completed the study. After 2 weeks of treatment, the total score of PSQI in the AA group was 4.6 ± 2.4 and in the PA group was 12.9 ± 1.8 ( = 3.91,<.1). The SAS, SDS score in the AA group were 39.9 ± 5.6/39.9 ± 5.9 and in the PA group were 59.7 ± 6.1/61.2 ± 4.4 ( = 3.38/4.9,<.1). The sleep rate were 93.8% and 25.0% (<.1). During the 1 month follow-up period, the PSQI total score in the AA group (5.2 ± 1.9) was superior to the PA group (13.1 ± 1.8) ( = 4.27,<.1). The SAS, SDS score in the AA group were 40.4 ± 5.1/42.7 ± 6.6 and in the PA group were 63.7 ± 6.6/63.5 ± 4.8 ( = 3.95/3.60,<.1). Throughout the study period, the 'six component' scores of PSQI in the AA group was superior to the PA group (each<.1). Except for tingling and cooling, other acupuncture sensations were significant differences (each<.1). Compared to the placebo acupuncture, active acupuncture can significantly improve insomnia, and clinical efficacy is maintained for at least 6 weeks.

STUDY OBJECTIVES:Despite considerable evidence supporting cognitive behavioral therapy for insomnia (CBT-I) for chronic insomnia, it remains untested within the context of acute insomnia. This study examined the efficacy of a single session of CBT-I, with an accompanying self-help pamphlet, for individuals with acute insomnia.

DESIGN:A pragmatic parallel group randomized controlled trial.

SETTING:Community.

PARTICIPANTS:Forty adults (mean age 32.9± 13.72 y) with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defined insomnia disorder, except a self-reported duration of less than 3 mo (i.e., acute insomnia), who reported no previous exposure to CBT-I and were not currently taking medication for sleep.

INTERVENTIONS:A single 60- to 70-min session of CBT-I (n = 20), with an accompanying self-help pamphlet, or wait list control group (n = 20). All subjects were offered a full individual course of CBT-I on completion of the study, regardless of group allocation.

MEASUREMENTS AND RESULTS:Subjects completed sleep diaries and the Insomnia Severity Index (ISI) pretreatment and 1 mo following treatment. There were no between-group differences on baseline ISI scores or subjective sleep continuity. The intervention group reported significantly lower ISI scores than controls (t(38) 2.24, P<0.05) at follow-up. Further, using proposed ISI scores for identifying insomnia caseness (i.e.,≥ 10), 60% of those in the CBT-I group had remitted by 1 mo compared to 15% of those in the control group.

CONCLUSIONS:This single session of cognitive behavioral therapy for insomnia (CBT-I) is sufficiently efficacious for a significant proportion of those with acute insomnia. The results are discussed in terms of integrating this brief form of CBT-I into the"stepped care"model of insomnia.

TRIAL REGISTRATION:Testing the efficacy of an early intervention for acute insomnia (SRCTN05891695) http://www.controlled-trials.com/ISRCTN05891695.

INTRODUCTION: Patients with atopic dermatitis suffered from night-time wakening, but the exact mechanism of it was not known. Ghrelin was involved in growth hormone secretion, regulation of appetite, anxiety,night-time wakening and stress. METHODS: Thus salivary ghreli levels during the night were measured in 40 healthy children or 40 patients with atopic dermatitis with night-time wakening. Salivary ghrelin levels at 02:00 h were markedly elevated in patients with atopic dermatitis compared to those in healthy children. RESULTS: Neither viewing control non-humorous film nor viewing humorous film had any effect on healthy children. In contrast, viewing humorous film improved night-time wakening and reduced elevation of salivary ghrelin levels in patients with atopic dermatitis, while viewing control film failed to do so. CONCLUSION: Viewing humorous film may be useful in the treatment of night-time wakening in patients with atopic dermatitis.