Evidence map›Paper›PMID 40665297›Full record

SynthesisBMC psychiatry2025

Psychotherapeutic, pharmacological and other active interventions from the NICE guideline for post-traumatic stress disorder with sleep disorder: systematic review and meta-analysis.

Yi-Fan Zhao, Cheng-Yang Huang, Zhi-Xin Zhang, Run-Ben Liu, Jia-Ling Liu, Xiao-Zheng Li, Guang-Ling Guo, Chao Zhang

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yi-Fan Zhao *Center for Evidence-Based Medicine and Clinical Research, Hubei Provincial Clinical Research Center of Central Nervous System Repair and Functional Reconstruction, Hubei, Shiyan, 442000, China.
Cheng-Yang Huang *Center for Evidence-Based Medicine and Clinical Research, Hubei Provincial Clinical Research Center of Central Nervous System Repair and Functional Reconstruction, Hubei, Shiyan, 442000, China.
Zhi-Xin ZhangCenter for Evidence-Based Medicine and Clinical Research, Hubei Provincial Clinical Research Center of Central Nervous System Repair and Functional Reconstruction, Hubei, Shiyan, 442000, China.
Run-Ben LiuCenter for Evidence-Based Medicine and Clinical Research, Hubei Provincial Clinical Research Center of Central Nervous System Repair and Functional Reconstruction, Hubei, Shiyan, 442000, China.
Jia-Ling LiuCenter for Evidence-Based Medicine and Clinical Research, Hubei Provincial Clinical Research Center of Central Nervous System Repair and Functional Reconstruction, Hubei, Shiyan, 442000, China.
Xiao-Zheng LiCenter for Evidence-Based Medicine and Clinical Research, Hubei Provincial Clinical Research Center of Central Nervous System Repair and Functional Reconstruction, Hubei, Shiyan, 442000, China.
Guang-Ling GuoCenter of Women's Health Sciences, Taihe Hospital, Hubei University of Medicine, Hubei, Shiyan, 420000, China. guoguangling1208@163.com.
Chao ZhangCenter for Evidence-Based Medicine and Clinical Research, Hubei Provincial Clinical Research Center of Central Nervous System Repair and Functional Reconstruction, Hubei, Shiyan, 442000, China. zhangchao0803@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPost-traumatic stress disorder (PTSD) is strongly associated with sleep disorders, and current clinical guidelines for PTSD differ in recommending treatment for patients with PTSD associated with sleep disorders. This meta-analysis evaluates the acceptability and efficacy of psychotherapy, pharmacotherapy, and other complementary/alternative therapies, to help clinicians make decisions about treatment regimens for individuals with PTSD and sleep disorders.

methodWe systematically searched PubMed, EMBASE, the Cochrane Library, and American Psychological Association PsyNet for randomized controlled trials (RCTs) related to placebo-controlled and active intervention trials for PTSD with sleep disorders up to February 2, 2023.

resultsActive intervention significantly improved PTSD (standardized mean difference (SMD) = 0.86, 95% confidence interval (CI): 1.21, 0.50), sleep disorders (SMD = 1.06, 95%CI: 1.50, 0.63), and depression (SMD = 0.58, 95%CI: -0.96, -0.19). Regarding compliance, the active intervention group did not show lower acceptability ((Risk ratios (RR) = 1.08, 95%CI: 0.92, 1.26). Compared to placebo or supportive groups, the active intervention did not exhibit statistically significant improvements in total sleep time (SMD = 0.87, 95%CI: -0.27, 1.47) and overall psychological symptoms (SMD = 0.13, 95%CI: -0.12, 0.37). Details results of the subgroup analyses were provided in the text. Bias may be present in total PTSD symptoms, change of total sleep symptoms and change of depression symptoms, and no significant bias was observed in acceptability.

conclusionActive intervention effectively reduces the main symptoms of PTSD in patients with sleep disorders. Consideration of pharmacotherapy (hydroxyzine) is recommended over prazosin, as suggested by the WFSBP clinical guidelines, especially when patients are insensitive to psychotherapy or have urgent symptoms. Psychological interventions, particularly IRT or IRT plus CBT-I, are recommended. Stratified by population, psychotherapy is more advisable for veterans and those with involuntary sexual experiences, while pharmacotherapy is more suitable for military staff. For patients with only nightmare symptoms, both psychotherapy and pharmacotherapy could be considered. When patients have insomnia symptoms, psychotherapy is preferable. The effect of psychotherapy is particularly recommended for females, while the effect of pharmacotherapy is emphasized for males.

Indexed as

Practice Guidelines as TopicPsychotherapySleep Wake DisordersStress Disorders, Post-TraumaticHumansCognitive behavioral therapyHydroxyzineImagery rehearsal therapyPost-traumatic stress disorderSleep disorders

Identifiers

PMID40665297
PMCPMC12265140

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.