For how we live.
SleepCARE randomised 219 Australian women receiving chemotherapy for breast cancer to CBT-I, bright light therapy, both, or sleep hygiene. Only CBT-I moved insomnia — and nothing moved fatigue.
Two American guideline bodies grade cognitive behavioural therapy for insomnia as a strong recommendation. Every drug in the sleep-medicine guideline — the ones it endorses and the ones it rejects — came out weak.
A meta-analysis of fully automated programmes found a large effect on insomnia severity. A review of 68 studies found the field has barely measured whether recipients find them acceptable.
A four-arm randomised trial in 112 young women tested whether high-intensity circuit training and sleep-health counselling add up. On objective measures they did — by minutes.
Forty-two trials show sleep-hygiene education helps a little and helps less than the alternatives. The sleep-medicine guideline suggests clinicians not use it on its own.
Fourteen Swedish primary care patients were interviewed alongside a trial of nurse-led group sleep restriction therapy. Depression and life circumstances were what got in the way.
In 311 adults aged 55 to 95, remission rates were 40% and 51% in the two intervention arms at one year, against 16% for online patient education. Adding human support helped a little.