Abstract
Background/Purpose: Post-stroke patients often have sleep and emotional problems. Cognitive behavioral therapy has been recommended to be included in the treatment of insomnia patients. However, its effectiveness in treating stroke-related sleep and emotional problems is unclear. This systematic review aims to explore the effect of cognitive behavioral approach while application in stroke patients.
Method: This study searched for research literature before October 2024 in nine Chinese and English databases including Pubmed, Cochrane, CINAHL, PsycArticles, Embase, Medline, CNKI, CEPS (Huayi), and SportDiscus with Full Text, regardless of age and gender , no language restrictions in Chinese and English, the research design adopts a randomized controlled trial (RCT), and uses the Medical Library Title Sheet (MeSH) and natural language which defined literature search terms to conduct P+I+O data retrieval. Keywords: 1. P: stroke , 2. I: cognitive behavioral therapy,mental healing, 3. O: Sleep quality, insomnia, Sleep Disorder*, Sleeplessness ,use Cochrane Risk of Bias 2.0 to evaluate the quality of research literature, and use RevMan 5.4 software to analyze the results.
Results: A total of 522 people were included in 6 RCTs. After heterogeneity and group analysis and comparison with the use of drugs or conventional treatment, the results were as follows: SMD = -0.43, 95% CI (-0.80, -0.06), p < 0.02, showing It can improve sleep quality by 0.43 units (p = 0.02), heterogeneity Q = 19.73, p = 0.001, I2 = 75%. The subsequent subgroup analysis showed that different intervention times of cognitive behavioral treatment were ineffective in improving the subjective sleep quality of stroke patients for <4 weeks, and >8 weeks could improve sleep quality by 0.63 units (p = 0.02). Emotional problems can improve anxiety by 0.56 units (p <0.05) and depression by 0.92 units (p =0.05).
Conclusion/Practical Application: This review found that cognitive behavioral therapy can effectively improve the sleep quality of stroke patients compared with the use of Sedative-hypnotics or usual care, and the effect is significant when implemented for more than 8 weeks; it can also improve patients' anxiety and depression. However, due to the small number of included studies, the review found that there is still heterogeneity. Future research should continue to explore and strengthen blinding, sample size, and missing value analysis.
Notes
References:
Urcan, Z., & Kolcu, M. (2022, Feb). Effect of a Nurse-Led Education Program for Stroke Patients on Sleep Quality and Quality of Life: A Randomized Controlled Study. Clin Nurs Res, 31(2), 340-347.
Wang, X., Chen, J., Liu, Y. E., & Wu, Y. (2022). The Effect of Acceptance and Commitment Therapy on Psychological Nursing of Acute Cerebral Infarction with Insomnia, Anxiety, and Depression. Comput Math Methods Med, 2022, 8538656.
Cai, H., Wang, X.-P., & Yang, G.-Y. (2021). Sleep Disorders in Stroke: An Update on Management. Aging and disease, 12(2), 570-585.
Sigma Membership
Lambda Beta at-Large
Type
Poster
Format Type
Text-based Document
Study Design/Type
Systematic Review
Research Approach
Other
Keywords:
Sub-acute Care, Stroke Patients, Sleep Quality, Emotional Problems, Cognitive Behavioral Therapy
Recommended Citation
Chiu, Chia-Yu and Chung, Mei-Ling, "Cognitive Behavioral Therapy in Improving Sleep Quality and Emotional in Patients With Stroke" (2025). International Nursing Research Congress (INRC). 22.
https://www.sigmarepository.org/inrc/2025/posters_2025/22
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Cognitive Behavioral Therapy in Improving Sleep Quality and Emotional in Patients With Stroke
Seattle, Washington, USA
Background/Purpose: Post-stroke patients often have sleep and emotional problems. Cognitive behavioral therapy has been recommended to be included in the treatment of insomnia patients. However, its effectiveness in treating stroke-related sleep and emotional problems is unclear. This systematic review aims to explore the effect of cognitive behavioral approach while application in stroke patients.
Method: This study searched for research literature before October 2024 in nine Chinese and English databases including Pubmed, Cochrane, CINAHL, PsycArticles, Embase, Medline, CNKI, CEPS (Huayi), and SportDiscus with Full Text, regardless of age and gender , no language restrictions in Chinese and English, the research design adopts a randomized controlled trial (RCT), and uses the Medical Library Title Sheet (MeSH) and natural language which defined literature search terms to conduct P+I+O data retrieval. Keywords: 1. P: stroke , 2. I: cognitive behavioral therapy,mental healing, 3. O: Sleep quality, insomnia, Sleep Disorder*, Sleeplessness ,use Cochrane Risk of Bias 2.0 to evaluate the quality of research literature, and use RevMan 5.4 software to analyze the results.
Results: A total of 522 people were included in 6 RCTs. After heterogeneity and group analysis and comparison with the use of drugs or conventional treatment, the results were as follows: SMD = -0.43, 95% CI (-0.80, -0.06), p < 0.02, showing It can improve sleep quality by 0.43 units (p = 0.02), heterogeneity Q = 19.73, p = 0.001, I2 = 75%. The subsequent subgroup analysis showed that different intervention times of cognitive behavioral treatment were ineffective in improving the subjective sleep quality of stroke patients for <4 >weeks, and >8 weeks could improve sleep quality by 0.63 units (p = 0.02). Emotional problems can improve anxiety by 0.56 units (p <0.05) and depression by 0.92 units (p =0.05).
Conclusion/Practical Application: This review found that cognitive behavioral therapy can effectively improve the sleep quality of stroke patients compared with the use of Sedative-hypnotics or usual care, and the effect is significant when implemented for more than 8 weeks; it can also improve patients' anxiety and depression. However, due to the small number of included studies, the review found that there is still heterogeneity. Future research should continue to explore and strengthen blinding, sample size, and missing value analysis.
Description
This review found that cognitive behavioral therapy can effectively improve the sleep quality of stroke patients compared with the use of Sedative-hypnotics or usual care, and the effect is significant when implemented for more than 8 weeks; it can also improve patients' anxiety and depression.