Interventions for Post-Stroke Insomnia: Evidence Mapping of Systematic Reviews and Meta-Analyses
Chao-qin Gou, Xiao-xia Li, Qin Yang, Li-xia Guo, Zhi-juan LiObjective
This study employed an evidence map to comprehensively synthesize the existing systematic reviews and meta-analyses (SRs/MAs), including network MAs (NMAs), visually presenting current evidence landscapes, research gaps, and quality ratings.
Methods
PubMed, Web of Science, Embase, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP, and Chinese Biological Medicine Database were searched from inception to May 27, 2025. The designs of SRs/MAs were collected. Data were extracted from the final selected studies. The A Measurement Tool to Assess Systematic Reviews scale was used to assess the quality of SRs/MAs and the Confidence in Network Meta-Analysis (CINeMA) tool for evaluating the quality of NMAs. Evidence mapping served as a methodological framework for synthesizing and visually presenting current SRs/MAs.
Results
A total of 848 studies were retrieved, and 27 were finally included. Interventions predominantly fell within traditional Chinese medicine (TCM) frameworks, with acupuncture accounting for the largest proportion. SRs/MAs incorporated 7–70 randomized controlled trials, involving sample sizes ranging from 435 to 5,526 participants. The quality assessment primarily employed the Cochrane risk-of-bias tool, while funnel plots were the most common method for evaluating publication bias. Only three high-quality studies were identified in the evidence map, with the majority of evidence residing in moderate-to-low-quality tiers.
Conclusion
Although the included SRs/MAs reported that compared to sedative–hypnotics, TCM interventions may potentially yield superior total effective rates and more favorable safety; it required further validation through high-quality evidence. Future SRs/MAs should prioritize interventions with insufficient or low-quality evidence and ensure prospective registration, Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant reporting, quantitative publication bias analyses, and International Prospective Register of Systematic Reviews checks to avoid redundancy.