Table 2. Summary of findings by GRADE quality assessment.
| Outcomes | No of studi-es | Certainty assessment | No of patients | Absolute effect (95% Cl) | Consistency | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Study design | Risk of bias | Inconsis- tency | Indirect- ness | Impreci- sion | Other consider- ations | WS | Placebo | ||||
| Overall sleep | 5 | Random-ized trials | Not serious | Seriousa | Not serious | Not serious | None | 972 | 792 | SMD 0.59 lower (0.75 lower to 0.42 lower) | ⨁⨁⨁◯ MODERATE |
| Sleep by Sleep Quality Scale | 4 | Random-ized trials | Not serious | Seriousa | Not serious | Seriousb | None | 135 | 93 | SMD 1.16 lower (1.65 lower to 0.66 lower) | ⨁⨁◯◯ LOW |
| Sleep by sleep onset latency | 3 | Random-ized trials | Not serious | Not serious | Not serious | Seriousb | None | 152 | 129 | SMD 0.53 lower (0.77 lower to 0.29 lower) | ⨁⨁⨁◯ MODERATE |
| Sleep by total sleep time | 3 | Random-ized trials | Not serious | Not serious | Not serious | Seriousb | None | 152 | 129 | SMD 0.45 lower (0.69 lower to 0.21 lower) | ⨁⨁⨁◯ MODERATE |
| Sleep by wake time after sleep onset | 3 | Random-ized trials | Not serious | Not serious | Not serious | Seriousb | None | 152 | 129 | SMD 0.39 lower (0.62 lower to 0.15 lower) | ⨁⨁⨁◯ MODERATE |
| Sleep by sleep efficiency | 3 | Random-ized trials | Not serious | Seriousa | Not serious | Seriousb | None | 152 | 129 | SMD 0.68 lower (1.07 lower to 0.29 lower) | ⨁⨁◯◯ LOW |
| Sleep by treatment duration- ≥8 weeks | 5 | Random-ized trials | Not serious | Not serious | Not serious | Not serious | None | 972 | 792 | SMD 0.37 lower (0.46 lower to 0.27 lower) | ⨁⨁⨁◯ MODERATE |
CI- Confidence interval, MD- Mean difference, SMD- Standardized mean difference, WS- Withania somnifera
Explanations: a. Substantial heterogeneity noted; b. Small sample size