考虑到与一般人群相比，癌症患者和幸存者的失眠症持续存在且患病率较高，因此需要有效的管理策略。这项系统评价和荟萃分析旨在全面评估药物和非药物干预措施对成年癌症患者和幸存者失眠疗效的现有证据。按照 PRISMA 指南，我们分析了涉及 6528 名参与者的 61 项随机对照试验的数据。干预措施包括药物、物理和心理治疗，重点关注失眠的严重程度以及继发性睡眠和非睡眠结果。采用频率论和贝叶斯分析策略进行数据合成和解释。失眠认知行为疗法 (CBT-I) 成为减轻癌症幸存者失眠严重程度的最有效干预措施，并进一步证明疲劳、抑郁症状和睡眠障碍有显着改善。焦虑。 CBT-I 显示出较大的干预后效果（g = 0.86；95%CI：0.57-1.15）和中等随访效果（g = 0.55；0.18-0.92）。其他干预措施，如 BWL 疗法、睡眠药物、褪黑激素、运动、身心疗法和正念疗法也显示出益处，但与 CBT-I 相比，其疗效的证据不太令人信服。对于正在接受积极癌症治疗的患者来说，简短的失眠行为疗法有望成为一种减轻负担的替代疗法。CBT-I 被支持作为癌症幸存者失眠的一线治疗方法，在睡眠和非睡眠结果方面观察到显着的益处。研究结果还强调了强度较低的替代方案的潜力。该研究为临床实践提供了宝贵的见解，并强调需要进一步探索癌症患者和幸存者睡眠障碍的复杂性。© 作者 2024。由牛津大学出版社出版。

Considering the persistent nature and higher prevalence of insomnia in cancer patients and survivors compared to the general population, there is a need for effective management strategies. This systematic review and meta-analysis aimed to comprehensively evaluate the available evidence for the efficacy of pharmacological and non-pharmacological interventions for insomnia in adult cancer patients and survivors.Following the PRISMA guidelines, we analyzed data from 61 randomized controlled trials involving 6528 participants. Interventions included pharmacological, physical, and psychological treatments, with a focus on insomnia severity and secondary sleep and non-sleep outcomes. Frequentist and Bayesian analytical strategies were employed for data synthesis and interpretation.Cognitive-Behavioral Therapy for Insomnia (CBT-I) emerged as the most efficacious intervention for reducing insomnia severity in cancer survivors, and further demonstrated significant improvements in fatigue, depressive symptoms, and anxiety. CBT-I showed a large post-intervention effect (g = 0.86; 95%CI : 0.57-1.15) and a medium effect at follow-up (g = 0.55; 0.18-0.92). Other interventions like BWL therapy, sleep medication, melatonin, exercise, mind-body therapies, and mindfulness-based therapies showed benefits, but the evidence for their efficacy was less convincing compared to CBT-I. Brief Behavioral Therapy for Insomnia showed promise as a less burdensome alternative for patients in active cancer treatment.CBT-I is supported as first-line treatment for insomnia in cancer survivors, with significant benefits observed across sleep and non-sleep outcomes. The findings also highlight the potential of less intensive alternatives. The research contributes valuable insights for clinical practice and underscores the need for further exploration into the complexities of sleep disturbances in cancer patients and survivors.© The Author(s) 2024. Published by Oxford University Press.