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However, the dynamic features of placebo effects have not been clarified. Our aim was therefore to conduct a meta\u2010analysis of placebo\u2010controlled randomized clinical trials to characterize the dynamic features of placebo effects addressing persistent insomnia disorder. We performed a comprehensive literature search for randomized, placebo\u2010controlled, double\u2010blind clinical trials evaluating the efficacy of therapeutic regimens addressing persistent insomnia disorder. We pooled separate effect size estimates (Hedge's <jats:italic>g<\/jats:italic>) of placebo and regimen conditions across trials for outcome measures, and multilevel mixed\u2010effects models were used to explore potential sources of heterogeneity. The placebo effects were significant and robust to improve the symptoms of insomnia, and subjective measures were significantly smaller than objective measures (<jats:italic>p\u00a0&lt;<\/jats:italic>\u00a0.001), but placebo response rates were nearly identical between subjective and objective measures. The overall placebo effects were influenced by publication year (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.015), treatment duration (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.010), sample size (<jats:italic>p\u00a0&lt;<\/jats:italic>\u00a0.001) and therapeutic regimen (<jats:italic>p\u00a0&lt;<\/jats:italic>\u00a0.001). Placebo effects showed a diphasic feature within treatment duration: initially a decrease and subsequently being stable; a sustained decline trend after withdrawals; and a steady\u2010to\u2010upward trend for a mixed therapeutic regimens in a large\u2010scale period over decades. The dynamic features of placebo effects addressing persistent insomnia disorder may lead to the development and validation of dosing strategies that require less medication exposure to maintain clinical effects.<\/jats:p>","DOI":"10.1111\/jsr.12997","type":"journal-article","created":{"date-parts":[[2020,2,13]],"date-time":"2020-02-13T07:40:21Z","timestamp":1581579621000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Dynamic features of placebo effects addressing persistent insomnia disorder: A meta\u2010analysis of placebo\u2010controlled randomized clinical trials"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2707-570X","authenticated-orcid":false,"given":"Binghu","family":"Jiang","sequence":"first","affiliation":[{"name":"Imaging Institute of Brain Function Department of Radiology Nanchong Central Hospital The Second Clinical Medical College North Sichuan Medical College Nanchong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongmei","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neurology Nanchong Central Hospital The Second Clinical Medical College North Sichuan Medical College Nanchong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwei","family":"Guo","sequence":"additional","affiliation":[{"name":"Imaging Institute of Brain Function Department of Radiology Nanchong Central Hospital The Second Clinical Medical College North Sichuan Medical College Nanchong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanhui","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Nephrology BenQ Medical Center The Affiliated BenQ Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2011.02.003"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1124\/pr.117.014381"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3001244"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2017.05.009"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.15683"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2014.10.018"},{"key":"e_1_2_8_9_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J.","year":"1988"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ijnp\/pyw022"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tips.2011.12.001"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrd3923"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)30307-8"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/eb-2017-102827"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2014.10.003"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31827688ee"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/030006059302100602"},{"key":"e_1_2_8_18_1","volume-title":"Cochrane handbook for systematic reviews of interventions. 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