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Table 2 Demography details of the studies

From: The effect of acceptance and commitment therapy on insomnia and sleep quality: A systematic review

Rows

Name and year

country

Study type

population

No. of participants intervention group,

Mean age (SD),

Female percent

Type of intervention,

Mode of delivery,

Sessions duration

No. of participants comparator,

Mean age (SD),

Female percent

Measures taken in the comparison group

Measurement criteria and tools

Follow up duration

Summary of outcome

Quality rate of study

1

Clarke, S. P.

2017 [27]

England

Pilot randomized controlled trial

Hip and knee osteoarthritis

16,

66 (7.3),

75%

ACT,

Groups of 4 to 6 people,

6 sessions 90 min per sessions,

6 week

15,

67 (10.7),

none

Sleep and well-being (ICOAP)

2 and 4 month follow up

The average score of sleep and well-being decreased slightly after two months of follow-up, which was not statistically significant. This score decreased again after a 4-month follow-up period, which was statistically significant. During this time, there was no change in the mean score of the control group.

26

2

Craner, J. R.

2020

[28]

America

Treatment outcome study

Chronic pain

137,

48.84 (16.31),

78.8%

ACT+ other treatment,

10 sessions,

2–4 h,

Almost 10 week,2 or 3 day per week

–

–

Insomnia (ISI)

–

The average score of insomnia decreased after treatment, and it was found that this treatment had a significant effect on improving insomnia, which was also statistically significant.

19

3

Farhang, Maryam

.2017

[29]

India

quasi-experimental clinical trial

Mental disorder patient

11,

33.54 (8.92),

All women

ACT,

8 sessions, 75 min per session, one month

11,

32.45 (11.3),

All women

Normal drug treatment

Anxiety and insomnia (GHQ)

–

The average score of anxiety and insomnia decreased during treatment which shows improvments;

This decrease was statistically significant. The score of the control group did not change significantly.

18

4

Herbert, M. S.

2017

[30]

America

Randomized Non-Inferiority clinical Trial

Chronic pain

128,

50 (13),

18%

In person: 65 individual,

Video-teleconference:63 individual

ACT and normal pain tratment,

In person, Video-teleconference,

8 session,

60 min

8 week,

–

–

Sleep quality (PSQI)

3 and 6 month follow up

The mean score of sleep quality changed slightly and was not observed in any of the modified intervention methods. The observed small changes were not statistically significant.

28

5

Hesser, Hugo.2012

[26]

Sweden

Randomized contorted trial

Tinnitus

35,

50.1 (16.4),

49.2%

ACT self-help internet delivered

(online ACT),

8 session,

120 min

8 week

1:Control group(32),

48.4 (14.2),

43.8%

2:CBT(32)

48.8 (13.4)

43.8%

1: None

2:CBT self-help internet delivered,

Face to face, 8 session,

120 min

8 week

Insomnia (insomnia severity index)

1 year follow up

The mean score of insomnia was reduced equally by CBT and ACT. However, follow-up after one year showed that the severity of insomnia in the ACT treatment method was almost higher than the initial state and the sleep intensity in CBT was almost back to normal.

The control group also showed a slight decrease in the severity of insomnia during the 2 months of treatment.

25

6

Jacobsen, Henrik Børsting.

2017

[31]

Norway

pre-post design

Chronic fatigue

140,

43.9 (9),

80.7%

ACT,

Groups and individual

8sessions,

150 min,

17 days

–

–

Insomnia (ISI)

–

A decrease in the mean score of the insomnia severity after treatment was observed, which was statistically significant.

21

7

Kallestad, H.

2015

[32]

Norway

Trial,

repeated measures treatment

Chronic fatigue

122,

44 (8.9),

80.3%

ACT,

Groups and individual

7sessions,

17 days,

–

–

Insomnia (ISI)

–

The mean score of insomnia decreased significantly after the intervention, which was statistically significant.

19

8

Khazaie, H.

2019

[21]

Iran

quasi-experimental clinical trial

Chronic Insomnia

12,

40.5 (8.36),

58.3%

ACT,

Individual

8 sessions,

60 min,

8 week

–

–

Sleep quality (PSQI)

3 month follow up

The average score of sleep quality after treatment and following a 3-month follow-up was decreased, which indicates the positive effect of ACT on sleep qauality.

20

9

Lang, A. J. 2017

[33]

America

Randomized controlled trial

Veterans with chronic pain

80,

34.5 (7.9),

19.3%

ACT,

individual sessions,

12 sessions,

60 min

80,

34.0 (8.1),

21.2%

present-centered therapy

(PCT),

12sessions,

60 min,

Insomnia (ISI)

3,6,9 and 12 month follow up

The mean score for insomnia severity was decreased significantly, after ACT treatment, and this was statistically significant. However, PCT did not have such an effect on improving insomnia.

26

10

Mosher, C. E. 2019 [34]

America

pilot randomized trial examined

Lung cancer

AND caregivers

50,

63.20 (11.27),

60%

ACT telephone based,

6 sessions,

50 min,

6 week

50,

62 (13.13),

64%

Education/Support,

other similar psychological intervention,

supportive listening and directing,

6 sessions

Sleep disturbance (PROMIS)4 Item

–

The mean score of insomnia did not change much following the intervention. The analysis of the Group X time effect did not show such a change. Moreover, the effect of other psychological interventions on sleep disorder was reported higher than ACT.

26

11

Mosher, C. E. 2018 [35]

America

pilot randomized trial examined

Metastatic breast cancer

23,

59.30

(11.95),

All women

[19]

ACT telephone based,

6sessions,

50–60

Minutes,

6 week.

24,

53.29 (10.93),

Education/Support,

6 sessions

All women

Sleep-related impairment (PROMIS)8 item,

Sleep disturbance (PROMIS) 4 item

8 AND 12 week follow up

The ACT intrvention group showed little improvement in sleeplessness after 8 and 12 weeks of follow-up, however, this was not statistically significant.

27

12

Päivi, Lappalainen.2019 [36]

Finland

randomized controlled trial

insomnia

43,

56.05 (11.05),

74.4%

ACT Internet-delivered self-help,

6 sessions,

6 week

40,

50.78 (15.26),

52.5%

Control

Sleep quality (BNSQ),

Insomnia (ISI),

Sleeping difficulties (ESS),

Recognize insomnia from normal sleep (DBAS)

6 month follow up

The intervention had a positive and significant effect on improving sleep disorder, and sleep quality in patients with chronic insomnia.

25

13

Simister, H. D. 2018 [37]

Canada

randomized controlled trial

Fibromyalgia

34

(online ACT) + treatment as usual (TAU),

7 sessions

2 month

33

TAU,

Sleep quality (PSQI)

3 month follow up

ACT was effective in improving sleep quality during treatment, however decreased during follow-up. This effect was not statistically significant.

26

14

Vethe, Daniel. 2018

[38]

Norway

randomized controlled trial

Chronic fatigue

89,

61 (9),

85.4%

ACT,

Individual and group,

7 h per day,

17 days

–

–

Insomnia (ISI)

12 month follow up

The mean score of insomnia decreased significantly during the follow-up period, which was statistically significant.

25

15

Wells-Di Gregorio, S. M. 2019

[39]

America

Pilot randomized controlled trial

Advanced cancer

17,

55.59 (7.25),

76%

CBT-ACT,

face to face and video session, Two person and individual

3 sessions,

90 min,

6 week

11,

58.0 (9.35),

91%

TAU

Insomnia (ISI), sleep diary (SOL), (WASO (TST),

–

Improvement of sleep quality, sleep delay, ISI severity were significantly different between the intervention and control groups, from the beginning up to week 6.

24

16

Westin, V. Z. 2011 [40]

Sweden

randomized controlled trial

tinnitus

20,

53.5 (12.84),

64%

ACT,

Individual,

On average 8.37 sessions per person and maximum of 10 sessions,

1)20,

48.95 (14.5),

40%

2)22,

49.59 (11.86),

36%

1) tinnitus treatment therapy (TRT)

2)control

Insomnia (ISI)

6 month follow up

Mean score for insomnia severity in the ACT intervention group decreased after treatment over 6-month, 18-month follow-up periods, and this was statistically significant. TRT intervention did not have a positive effect on improving sleep quality.

25

17

Wiklund, T. 2018 [41]

Sweden

randomized controlled trial

chronic pain

81

ACT-bsm,

Groups,

7 session,

120

Minutes,

8 week

1)78,

2)73

1)Exercise

2) control

Insomnia (ISI)

6 and 12 month follow up

The average insomnia score in ACT intervention decreased after treatment and the 6 months follow-up, which was not statistically significant. The 12-month follow-up also showed a decrease in the insomnia, which was statistically significant. The effect of exercise on improving sleep quality was also evident, which was significant.

25

18

Zakiei, A.

2019

[42]

Iran

Single-arm Trial Plan

Insomnia

4,

38.5 (10.37)

50%

ACT,

8 sessions,

Individual,8 week

–

–

DBAS,

SPA,

PSQI,

Sleep diary (TST,

SOL,

SE)

3 month follow up

ACT improves sleep quality in people with insomnia. This situation was also observed during the follow-ups.

20

19

Zetterqvist, V. 2018 [43]

Sweden

clinical pilot study

Chronic pain

16,

38.19

(14.13),

68.8%

ACT,

Group and sometimes individual

6 sessions and 1 sessions in the follow up,

120 min,

–

–

Insomnia (ISI),

Sleep diary((SE), (SOL), (WASO), (TST))

3 month follow up

In general, the intervention has a direct effect on improving the insomnia severity and other parameters related to sleep quality.

23