Non-pharmacological insomnia interventions for improving sleep and mood in people with neurological disorders: A systematic review and meta-analysis

Sleep Med. 2025 Oct 27;137:106887. doi: 10.1016/j.sleep.2025.106887. Online ahead of print.

ABSTRACT

INTRODUCTION: Insomnia is prevalent among individuals with neurological disorders and results in impaired sleep and mood. While evidence for non-pharmacological insomnia interventions is positive, they are typically developed for the general population, and their effectiveness in neurological populations, who face additional sleep and circadian challenges, remains unclear.

OBJECTIVE: To synthesize evidence on the effectiveness of non-pharmacological insomnia interventions for improving sleep and mood in individuals with neurological disorders.

METHODS: Randomized controlled trials (RCTs) were searched and reviewed across databases (Embase, Ovid-Medline, APA PsycInfo, Scopus, and Cochrane Library) for inclusion and analysis. Standardized mean differences (SMD) were estimated for sleep and mood outcomes using random-effects models.

RESULTS: Nine RCTs were identified from a total of 1645 studies. Non-pharmacological interventions were effective in improving sleep quality (SMD = 1.36, 95 % confidence interval (CI) [0.68, 2.04]) and reducing insomnia symptoms (SMD = -0.90, 95 % CI [-1.25, -0.56]). Mood outcomes also improved, with reductions in depression (SMD = -0.45, 95 % CI [-0.73, -0.18]) and anxiety symptoms (SMD = -0.46, 95 % CI [-0.66, -0.26]). Individual- and group-based interventions were comparable in improving sleep, whereas only individual-based interventions were effective in improving mood. In-person interventions yielded larger effects on sleep, whereas digital interventions yielded larger effects on mood.

CONCLUSION: Non-pharmacological insomnia interventions are effective in improving sleep and mood in neurological populations, although their effects are attenuated compared to those in the general population. Intervention effects vary based on delivery mode and format, underscoring the need for further research into optimal approaches to enhance treatment effectiveness.

PMID:41176810 | DOI:10.1016/j.sleep.2025.106887