Global clinical benefits of cognitive-behavioral therapy for insomnia and mindfulness-based therapy applied to fibromyalgia: systematic review and metaanalysis
M. Pilar Martínez, Elena Miró, and Ana I. Sánchez
Cognitive-behavioral therapy focused on insomnia (CBT-I) is useful to improve sleep and other manifestations of fibromyalgia (FM). It has also been suggested that mindfulness-based therapy (MBT) may help alleviate insomnia, but it is unknown whether its clinical benefits are higher than CBT-I on FM. This review analyzes the value of the MBT to address sleep, pain, depression and impairment in FM and its differential efficacy regarding CBT-I. The MEDLINE, PsyARTICLES, SCOPUS and Cochrane Library databases for the period 2000-2015 were examined, and randomized controlled trials that implemented CBT-I or MBT in patients with FM were selected, and 11 studies were identified. CBT-I achieved higher changes than MBT in sleep but lower changes in pain, and both therapies achieved significant improvements in depression and impairment, although favorable magnitude to CBT-I. The possibility of extending the clinical benefits that enable CBT-I on the FM incorporating the principles of mindfulness is suggested.