| Objective To systematically investigate the effect of repeated transcranial magnetic stimulation ( rTMS) on subjective sleep quality in patients with insomnia, so as to provide evidence - based basis for the treatment of insomnia by rTMS. Methods Randomized controlled trials ( RCTs ) about the treatment of insomnia by rTMS published in foreign and domestic databases, including PubMed, Embase, Cochrance Library, Wanfang, VIP, Chinese biomedical literature database and CNKI were retrieved. The following procedures including literature selection, data extraction and quality evaluation were performed independently by two researchers. Then the RevMan 5. 2 was used for meta - analysis and Stata 13. 0 was used for publication bias analysis.Results A total of 13 RCTs ( n = 889) were enrolled. Meta - analysis results showed that the sleep quality improvement effect of the rTMS group was better than that of the control group ( SMD = - 1 . 11 , 95% CI: - 1 . 46 ~ - 0. 76, Z = 6. 22, P < 0. 01 ) . Subgroup analysis showed that the sleep quality improvement effect for primary and secondary insomnia patients in rTMS group was better than that in control group ( primary: SMD = - 1 . 22, 95% CI: - 1 . 72 ~ - 0. 72, Z = 4. 77, P < 0. 01 ; secondary: SMD = - 1 . 04, 95%CI: - 1 . 55 ~ - 0. 54, Z = 4. 04, P < 0. 01 ) . The sleep quality improvement effect of high - frequency and low - frequency rTMS was better than that of control group ( high - frequency: SMD = - 0. 44, 95% CI: - 0. 76 ~ - 0. 13, Z = 2. 73, P < 0. 01 ; low -frequency: SMD = - 1 . 24, 95% CI: - 1 . 61 ~ - 0. 86, Z = 6. 45, P < 0. 01 ) . Conclusion High - frequency or low - frequency rTMS combined with conventional therapy can effectively ameliorate the subjective sleep quality of insomniacs, which is also effective for both primary and secondary insomnia. |