Table 4.
Evidence summary and GRADE analysis
| Comparison | Outcome period (quantitative sleep measures) | Conclusion | Quantity and type of evidence | Starting level of evidence strength | Quality | Inconsistency | Directness | Sparse or imprecise | Reporting bias | Strong or very strong association | Dose-resp. | Confounders would increase eff. | Final level of evidence strength |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CBT-I vs. benzodiazepines |
Short term |
Improved less with CBT-I |
3 RCT |
High |
–2 |
–1 |
0 |
0 |
0 |
0 |
0 |
0 |
Very low |
| |
Long term |
Improved more with CBT-I |
3 RCT |
High |
–1 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Moderate |
| CBT-I vs. non-benzodiazepines |
Short term |
Improved more with CBT-I |
2 RCT |
High |
–1 |
0 |
0 |
0 |
0 |
0 |
0 |
0 |
Moderate |
| Long term | Improved more with CBT-I | 1 RCT | High | –1 | 0 | 0 | –1 | 0 | 0 | 0 | 0 | Low |
Evidence assessed using methods of the GRADE Working Group [26-28].
Evidence strength ratings:
High: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low: Any estimate of effect is very uncertain.
Short term outcomes typically 4 to 8 weeks, long-term outcomes typically 6 to 12 months.