The impact of community-based, common, non-pharmaceutical interventions on sleep in patients with fibromyalgia: a systematic review and network meta-analysis.

Objectives: Patients with fibromyalgia syndrome (FM) often suffer from sleep disorders, adversely affecting their prognosis. Active non-pharmacological therapies are considered the mainstay of treatment for FM, but the optimal treatment choice remains contentious. We aimed to compare and rank community-based non-pharmacological interventions for FM with sleep disorder by quantifying information from randomised controlled trials (RCTs).

Methods: Two authors independently selected studies and extracted data. We searched Embase, MEDLINE, PubMed, CNKI, Scopus, Google Scholar, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) from the database inception to June 2022. Network meta-analyses were conducted using a frequency-based method. The study protocol is registered with the Prospective Register of Systematic Reviews (PROSPERO, CRD 42022373704). Eleven RCTs (n=729) were included in the analysis.

Results: Mindfulness-based therapy (MBT) (SMD=-0.84 (95% CI: -1.49 to -0.20)) and cognitive behavioural therapy (CBT) (SMD=-0.54 (95% CI: -1.04 to -0.04)) were associated with significantly improved sleep symptoms in a patient with FM compared with usual care.

Conclusions: MBT exhibited the highest probability (91.14%) of being the most effective intervention in sleep improvement, followed by CBT (72.39%). MBT exhibited marked advantages over other interventions and is likely to have optimal efficacy in ameliorating sleep disorders.