# Long pre-bed bath × sleep-onset latency

Verdict 2993 · Evidence Check

Stored-material review date: Not recorded  
Original evidence cut-off: 2026-09-07  
Review-criteria version: 1.0  
Public page/material preparation date: 2026-10-16

Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect.

## Assessment scope

- Population: Core S01 Maeda 2023 is a home crossover trial with 23 adults. Exact ages, sex, insomnia diagnoses, eligibility, recruitment and condition-specific analysis/completion denominators are unverified. Older women with insomnia and nine participants in original S02 Dorsey 1996 bibliography are a separate supporting context; another nine-person mention is unlinked to bibliography. Participants/nights are not added together.
- Ingredient, formulation and route: Original S01 distinguishes 40°C shower alone, shower plus about five minutes of bathing and shower plus about 16 minutes. Chest-level immersion, mean long-bath exposure of 16.1 minutes and ending 1.5–2 hours before bed identify study exposure. They are not bathing, sleep or treatment instructions.
- Dose: Temperature, immersion, bathing duration and pre-bed interval are preserved only as original study exposure. Mean long-bath exposure of 16.1 minutes and sleep onset of 16.1±13.9 minutes after the short bath are different values. Individual distributions, temperature maintenance, interval adherence and actual deviations are unverified; no new doses, total times or schedules are calculated.
- Comparator: An active control that already received a 40°C shower. Original categorization as no bath does not mean no heating or no intervention. There was no shower-alone versus no-heating comparison, so results are not transferred into shower efficacy.
- Measured outcome: The selected outcome is actigraphic sleep-onset latency (SOL). Retain shower 20.3±14.3 minutes, short bath 16.1±13.9, long bath 12.3±10.1, long-bath versus shower P<.05, original simple mean difference −8.0 minutes and subclaim note of eight minutes. Exact within-person estimands, 95% CI, meaning of ±, prospective primary outcome and models are unverified. Null condition differences in sleep efficiency of 78.69%, 80.30% and 82.05%, and perceived sleep quality, are separate.
- Duration: The original records three conditions in randomized order over approximately three weeks, analyzing one qualifying night per condition. Distinguish single exposure, selected nights and the operational period; this is not extended into daily three-week treatment, long-term effects or insomnia treatment.
- Questions outside this scope: Converting active shower control into no heating/no intervention or establishing shower-alone efficacy; Mixing mean bath exposure of 16.1 minutes with short-bath sleep onset of 16.1 minutes, or arbitrarily classifying ± as SD, SE or CI; Turning original simple −8.0 minutes into new arithmetic, crossover-adjusted effects or CIs, or SOL signals into SE, perceived quality or insomnia-treatment success; Treating one selected night as all nights/complete analysis of all 23 people, or adding participants/nights; Using supporting Dorsey nine-person and another unlinked nine-person mention as exact independent confirmation, new reports or participant totals; Inheriting parent C46, axes or historical checks as subclaim scores/completed current review, or creating bathing, sleep, treatment or procedure instructions

## Checklist items

### N01 · What is the original grade for the selected sleep-onset question?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The selected original claim is reduced sleep-onset latency after a long pre-bed bath, graded C, with a note that its simple mean was 8 minutes shorter than shower. The subclaim has no score, status or assessment axes; parent C46 is not substituted.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: A separate subclaim score, status and assessment axes are absent from the source.
- Required materials and conditions: Original subclaim, note, grade and parent context
- Materials to obtain first: A separate subclaim score, status and assessment axes are absent from the source.
- Further research: Material needed: A separate subclaim score, status and assessment axes are absent from the source. This records needed materials; no new research was executed.
- Conditions for verification: Material for Original subclaim, note, grade and parent context must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Original subclaim, note, grade and parent context with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01, S02

### N02 · Who entered the core crossover trial, and what are the denominators?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: S01 Maeda2023 was a home crossover trial in 23 adults. This does not establish diagnosed insomnia, all ages or 23 nights per condition.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Exact age, sex, insomnia status, eligibility, recruitment and condition-specific analysis denominators are unverified.
- Required materials and conditions: S01 eligibility, baseline sleep and condition-specific analysis denominators
- Materials to obtain first: Exact age, sex, insomnia status, eligibility, recruitment and condition-specific analysis denominators are unverified.
- Further research: Material needed: Exact age, sex, insomnia status, eligibility, recruitment and condition-specific analysis denominators are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for S01 eligibility, baseline sleep and condition-specific analysis denominators must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects S01 eligibility, baseline sleep and condition-specific analysis denominators with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N03 · What was the long-bath research exposure?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The original S01 conditions were 40°C, chest-level immersion, mean long-bath duration 16.1 minutes and ending 1.5–2 hours before bed. These identify the research exposure and are not bathing or sleep instructions.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Individual exposure distributions, temperature maintenance, adherence to the bedtime interval and actual deviations are unverified.
- Required materials and conditions: Temperature, immersion, exposure duration and end time
- Materials to obtain first: Individual exposure distributions, temperature maintenance, adherence to the bedtime interval and actual deviations are unverified.
- Further research: Material needed: Individual exposure distributions, temperature maintenance, adherence to the bedtime interval and actual deviations are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Temperature, immersion, exposure duration and end time must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Temperature, immersion, exposure duration and end time with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N04 · Was the actual comparator an active shower condition?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: S01 compared 40°C shower alone, shower followed by an approximately 5-minute bath and shower followed by an approximately 16-minute bath. The comparator already received a warm shower; it was not no heating or no intervention.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Quantitative information on shower exposure, contact and thermal differences between conditions is unverified.
- Required materials and conditions: Distinguishing shower alone from shower followed by bath
- Materials to obtain first: Quantitative information on shower exposure, contact and thermal differences between conditions is unverified.
- Further research: Material needed: Quantitative information on shower exposure, contact and thermal differences between conditions is unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Distinguishing shower alone from shower followed by bath must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Distinguishing shower alone from shower followed by bath with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N05 · Are short/long exposure durations the same as sleep-onset latency?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: Approximately 5 minutes for the short bath and 16 minutes for the long bath are exposure durations, distinct from sleep-onset latency of 16.1±13.9 and 12.3±10.1 minutes. Mean long-bath duration 16.1 minutes is also separate from mean sleep-onset latency 16.1 minutes after the short bath.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Exposure-duration distributions and an independent comparison of duration and thermal exposure are unverified.
- Required materials and conditions: Units of actual condition-specific exposure and sleep-onset outcomes
- Materials to obtain first: Exposure-duration distributions and an independent comparison of duration and thermal exposure are unverified.
- Further research: Material needed: Exposure-duration distributions and an independent comparison of duration and thermal exposure are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Units of actual condition-specific exposure and sleep-onset outcomes must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Units of actual condition-specific exposure and sleep-onset outcomes with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N06 · Are randomized order, washout and period effects known?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: S01 describes experiencing three conditions in randomized order over approximately 3 weeks. This is not converted into verified allocation concealment, sufficient washout or carryover control.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Sequence generation, concealment, intervals between conditions and period/carryover models are unverified.
- Required materials and conditions: Condition sequence, period, carryover and within-person analysis
- Materials to obtain first: Sequence generation, concealment, intervals between conditions and period/carryover models are unverified.
- Further research: Material needed: Sequence generation, concealment, intervals between conditions and period/carryover models are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Condition sequence, period, carryover and within-person analysis must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Condition sequence, period, carryover and within-person analysis with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N07 · How was the selected night chosen for analysis?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The stored account records actigraphy analysis of one qualifying night per condition. This is not expanded into an average of all nights over approximately 3 weeks or complete analysis of all 23 participants.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Night-selection criteria, prospective specification, candidate, selected and excluded nights per condition and reasons for missingness are unverified.
- Required materials and conditions: Condition-specific night selection, missingness and prospective rules
- Materials to obtain first: Night-selection criteria, prospective specification, candidate, selected and excluded nights per condition and reasons for missingness are unverified.
- Further research: Material needed: Night-selection criteria, prospective specification, candidate, selected and excluded nights per condition and reasons for missingness are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Condition-specific night selection, missingness and prospective rules must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Condition-specific night selection, missingness and prospective rules with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N08 · How was actigraphic sleep-onset latency defined?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The original S01 endpoints were actigraphic sleep-onset latency, sleep efficiency and perceived sleep quality. The selected outcome is sleep-onset latency (SOL), preserving original values in minutes.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: The sleep-onset algorithm, device, bedtime reference, validation and measurement error are unverified.
- Required materials and conditions: SOL definition, device, algorithm and units
- Materials to obtain first: The sleep-onset algorithm, device, bedtime reference, validation and measurement error are unverified.
- Further research: Material needed: The sleep-onset algorithm, device, bedtime reference, validation and measurement error are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for SOL definition, device, algorithm and units must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects SOL definition, device, algorithm and units with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N09 · What were the original condition-specific SOL values and P value?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: Shower 20.3±14.3 minutes, short bath 16.1±13.9 minutes, long bath 12.3±10.1 minutes and long bath versus shower P<.05 are preserved. The ± values are not reclassified as SD, SE or CI without verification.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: The exact statistical definition of ±, condition-specific denominators, test model and exact P value are unverified.
- Required materials and conditions: Original SOL values, analysis scope and test
- Materials to obtain first: The exact statistical definition of ±, condition-specific denominators, test model and exact P value are unverified.
- Further research: Material needed: The exact statistical definition of ±, condition-specific denominators, test model and exact P value are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Original SOL values, analysis scope and test must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Original SOL values, analysis scope and test with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N10 · Is the simple −8.0-minute difference separated from a comparative estimate?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The stored account's simple mean difference of −8.0 minutes and the subclaim note of 8 minutes are preserved as historical wording. They are not newly calculated or converted into an adjusted within-person effect or exact comparative CI.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: The within-person estimate, baseline/period adjustment, 95% CI and correlation structure are unverified.
- Required materials and conditions: Original simple difference, adjusted within-person effect and CI
- Materials to obtain first: The within-person estimate, baseline/period adjustment, 95% CI and correlation structure are unverified.
- Further research: Material needed: The within-person estimate, baseline/period adjustment, 95% CI and correlation structure are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Original simple difference, adjusted within-person effect and CI must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Original simple difference, adjusted within-person effect and CI with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N11 · Are the importance and persistence of shorter sleep onset known?

Verification status: Unverified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The preserved account describes a small sleep-onset signal. A simple mean of 8 minutes or P<.05 alone does not establish individual benefit, insomnia treatment or a lasting effect.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Relevance thresholds, individual distributions, measurement error and persistence over repeated nights are unverified.
- Required materials and conditions: Effect size, relevance threshold and repeated nights
- Materials to obtain first: Relevance thresholds, individual distributions, measurement error and persistence over repeated nights are unverified.
- Further research: Material needed: Relevance thresholds, individual distributions, measurement error and persistence over repeated nights are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Effect size, relevance threshold and repeated nights must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Effect size, relevance threshold and repeated nights with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N12 · Is the null sleep-efficiency result preserved separately?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: Sleep efficiency of 78.69%, 80.30% and 82.05% showed no between-condition difference. The sleep-onset signal is not transferred into improved objective sleep efficiency or overall restorative sleep.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: The exact SE definition, condition-specific denominators, comparative effect, CI and exact P value are unverified.
- Required materials and conditions: Outcomes and units of SOL and objective SE
- Materials to obtain first: The exact SE definition, condition-specific denominators, comparative effect, CI and exact P value are unverified.
- Further research: Material needed: The exact SE definition, condition-specific denominators, comparative effect, CI and exact P value are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Outcomes and units of SOL and objective SE must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Outcomes and units of SOL and objective SE with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N13 · Is perceived sleep quality distinguished from SOL and SE?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The stored account records improved perceived sleep quality with the long bath but says it does not replace null objective SE. It is not repurposed as the objective effect size for the selected SOL outcome.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: The scale, denominator, exact effect, CI, prospective hierarchy and expectation effects are unverified.
- Required materials and conditions: Subjective measure, masking and endpoint correspondence
- Materials to obtain first: The scale, denominator, exact effect, CI, prospective hierarchy and expectation effects are unverified.
- Further research: Material needed: The scale, denominator, exact effect, CI, prospective hierarchy and expectation effects are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Subjective measure, masking and endpoint correspondence must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Subjective measure, masking and endpoint correspondence with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N14 · Is masking of sleep-onset measurement and analysis known?

Verification status: Unverified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: This was a crossover trial with different bathing conditions at home. Objective actigraphy alone does not verify analyst masking or control of expectation effects.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Condition awareness, assessor/analyst masking, expectation differences and analyst involvement are unverified.
- Required materials and conditions: Assessor/analyst masking and differences in expectations
- Materials to obtain first: Condition awareness, assessor/analyst masking, expectation differences and analyst involvement are unverified.
- Further research: Material needed: Condition awareness, assessor/analyst masking, expectation differences and analyst involvement are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Assessor/analyst masking and differences in expectations must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Assessor/analyst masking and differences in expectations with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N15 · Were concurrent bedtime, lifestyle and environmental conditions equivalent?

Verification status: Unverified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The stored account records an approximately 3-week home crossover and analysis of selected nights. It does not establish that all bedtime conditions other than bathing were identical.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Sleep schedule, environment, alcohol, caffeine, medication, other lifestyle conditions and changes across periods are unverified.
- Required materials and conditions: Sleep schedule, environment, concurrent exposures and baseline differences
- Materials to obtain first: Sleep schedule, environment, alcohol, caffeine, medication, other lifestyle conditions and changes across periods are unverified.
- Further research: Material needed: Sleep schedule, environment, alcohol, caffeine, medication, other lifestyle conditions and changes across periods are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Sleep schedule, environment, concurrent exposures and baseline differences must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Sleep schedule, environment, concurrent exposures and baseline differences with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N16 · Are prospective endpoints, registration and SAP known?

Verification status: Unverified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The stored account records an unverified prospective primary endpoint. The original evidence row has no registration key and the citation has no registration identifier. The parent endpoint grouping does not prove a prospective hierarchy.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Registration, prospective SOL hierarchy, protocol, SAP, night selection and change history are unverified.
- Required materials and conditions: Prospective primary SOL, analysis plan and change history
- Materials to obtain first: Registration, prospective SOL hierarchy, protocol, SAP, night selection and change history are unverified.
- Further research: Material needed: Registration, prospective SOL hierarchy, protocol, SAP, night selection and change history are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Prospective primary SOL, analysis plan and change history must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Prospective primary SOL, analysis plan and change history with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N17 · Are multiple comparisons across conditions and endpoints distinguished?

Verification status: Unverified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: Three conditions are considered for SOL, SE and perceived sleep quality. Long bath versus shower P<.05 is not used as a prospective first analysis or success on every endpoint.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Test order, multiplicity adjustment, exact P values and prospective condition-specific contrasts are unverified.
- Required materials and conditions: Prospective testing plan for three conditions and multiple endpoints
- Materials to obtain first: Test order, multiplicity adjustment, exact P values and prospective condition-specific contrasts are unverified.
- Further research: Material needed: Test order, multiplicity adjustment, exact P values and prospective condition-specific contrasts are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Prospective testing plan for three conditions and multiple endpoints must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Prospective testing plan for three conditions and multiple endpoints with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N18 · Are adherence, exclusions and analysis populations known?

Verification status: Unverified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The 23 participants are the original account's participant count. Analysis of one selected night per condition is distinguished from adherence, exclusions and completion denominators; no new total number of nights is calculated.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Exposure adherence, analysis exclusions, missing conditions, ITT/PP, discontinuations and attrition reasons are unverified.
- Required materials and conditions: Planned/actual exposure, condition-specific attrition and ITT/PP
- Materials to obtain first: Exposure adherence, analysis exclusions, missing conditions, ITT/PP, discontinuations and attrition reasons are unverified.
- Further research: Material needed: Exposure adherence, analysis exclusions, missing conditions, ITT/PP, discontinuations and attrition reasons are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Planned/actual exposure, condition-specific attrition and ITT/PP must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Planned/actual exposure, condition-specific attrition and ITT/PP with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N19 · How direct is the supporting Dorsey citation?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: S02 Dorsey1996 is a supporting bibliography item present only in the original citations, described as older women with insomnia, 9 participants and a historical abstract check. It is not a core evidence row and does not inherit an external abstract reading in this work.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: The exact intervention, timing, denominator, SOL effect, CI, analysis criteria and correspondence to the core conditions are unverified.
- Required materials and conditions: S02 population, exposure, timing, endpoint and denominator
- Materials to obtain first: The exact intervention, timing, denominator, SOL effect, CI, analysis criteria and correspondence to the core conditions are unverified.
- Further research: Material needed: The exact intervention, timing, denominator, SOL effect, CI, analysis criteria and correspondence to the core conditions are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for S02 population, exposure, timing, endpoint and denominator must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects S02 population, exposure, timing, endpoint and denominator with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S02

### N20 · Which report corresponds to the other 9-person experiment in the text?

Verification status: Unverified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The original text mentions two older crossover experiments with 9 participants each and differences including older women with insomnia, healthy women and 30 minutes before bed. Only Dorsey is linked as a supporting citation; the other exact report and the mapping of those features remain unlinked. No new report is created.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: The additional experiment's bibliography, population, exposure timing, denominator, quantitative values and family relationship are unverified.
- Required materials and conditions: Bibliography, trial family and population of the additional mention
- Materials to obtain first: The additional experiment's bibliography, population, exposure timing, denominator, quantitative values and family relationship are unverified.
- Further research: Material needed: The additional experiment's bibliography, population, exposure timing, denominator, quantitative values and family relationship are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Bibliography, trial family and population of the additional mention must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Bibliography, trial family and population of the additional mention with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01, S02

### N21 · Are independent replication and condition heterogeneity distinguished?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The parent records favorable supporting directions but does not upgrade them to independent confirmation because populations and timing differ. The core 23, supporting 9 and unlinked 9 participants are not summed.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Separate replication under the same exposure, comparator and population, and independence of actual trial families are unverified.
- Required materials and conditions: Separate evidence with the same population, exposure, timing and comparator
- Materials to obtain first: Separate replication under the same exposure, comparator and population, and independence of actual trial families are unverified.
- Further research: Material needed: Separate replication under the same exposure, comparator and population, and independence of actual trial families are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Separate evidence with the same population, exposure, timing and comparator must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Separate evidence with the same population, exposure, timing and comparator with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01, S02

### N22 · Are a single exposure, approximately 3-week operations and long-term sleep the same?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The parent's single pre-bed intervention classification is distinguished from three conditions over approximately 3 weeks and one analyzed night per condition. This is not converted into daily treatment for 3 weeks or a long-term effect.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: No linked material establishes repeated use, long-term sleep, treatment in diagnosed patients or persistence after stopping.
- Required materials and conditions: One analyzed night, operational period and long-term outcomes
- Materials to obtain first: No linked material establishes repeated use, long-term sleep, treatment in diagnosed patients or persistence after stopping.
- Further research: Material needed: No linked material establishes repeated use, long-term sleep, treatment in diagnosed patients or persistence after stopping. This records needed materials; no new research was executed.
- Conditions for verification: Material for One analyzed night, operational period and long-term outcomes must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects One analyzed night, operational period and long-term outcomes with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N23 · Can this be generalized to other populations or insomnia treatment?

Verification status: Unverified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The core concerns sleep-onset outcomes in 23 selected adults; supporting older women with insomnia are a different context. The sleep-onset signal does not establish insomnia treatment or improved sleep for all populations.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Material directly applicable to diagnosed insomnia, other ages, diseases and living environments is not linked.
- Required materials and conditions: Direct eligibility, diagnosis and endpoint scope
- Materials to obtain first: Material directly applicable to diagnosed insomnia, other ages, diseases and living environments is not linked.
- Further research: Material needed: Material directly applicable to diagnosed insomnia, other ages, diseases and living environments is not linked. This records needed materials; no new research was executed.
- Conditions for verification: Material for Direct eligibility, diagnosis and endpoint scope must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Direct eligibility, diagnosis and endpoint scope with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01, S02

### N24 · Were effects of shower alone and other heating also tested?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The stored account says shower alone cannot be evaluated because shower versus no heating was not compared. The additional effect of a long bath versus a warm shower is not converted into shower efficacy or effects of all passive heating.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: No linked material establishes direct effects of shower alone versus no heating or other temperatures, durations and heating methods.
- Required materials and conditions: Direct shower-versus-no-heating and other-exposure comparisons
- Materials to obtain first: No linked material establishes direct effects of shower alone versus no heating or other temperatures, durations and heating methods.
- Further research: Material needed: No linked material establishes direct effects of shower alone versus no heating or other temperatures, durations and heating methods. This records needed materials; no new research was executed.
- Conditions for verification: Material for Direct shower-versus-no-heating and other-exposure comparisons must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Direct shower-versus-no-heating and other-exposure comparisons with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01

### N25 · Are funding, employee authors, product support and COI distinguished?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The original S01 funding record states funding not applicable and 2 authors affiliated with Noritz research and development. Funding wording and employee involvement are not expanded into verified product support, COI or all interests.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Funding roles, equipment/product support, research roles of employee authors, detailed COI and S02 support are unverified.
- Required materials and conditions: Separate source disclosures of support, employment and interests
- Materials to obtain first: Funding roles, equipment/product support, research roles of employee authors, detailed COI and S02 support are unverified.
- Further research: Material needed: Funding roles, equipment/product support, research roles of employee authors, detailed COI and S02 support are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Separate source disclosures of support, employment and interests must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Separate source disclosures of support, employment and interests with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01, S02

### N26 · How far is bathing safety verified?

Verification status: Unverified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: The parent's original safety value is Unknown, with systematic adverse-event denominators and rates unverified. Burns, dizziness and falls are generalization-limit wording in the stored account, not observed event rates.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: Condition-specific event definitions, collection, denominators, discontinuation, vulnerable populations and long-term safety are unverified.
- Required materials and conditions: Harm-event collection, exposures, denominators and discontinuation
- Materials to obtain first: Condition-specific event definitions, collection, denominators, discontinuation, vulnerable populations and long-term safety are unverified.
- Further research: Material needed: Condition-specific event definitions, collection, denominators, discontinuation, vulnerable populations and long-term safety are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Adverse-event collection, exposure, denominators and discontinuation must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Adverse-event collection, exposure, denominators and discontinuation with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01, S02

### N27 · Are parent values, subclaim grade and historical dates distinguished?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: Parent C46, B/S/R1/I1/EX/B2/CX, four false flags and an empty override are preserved alongside the subclaim C and note. Original Korean/English, 2026-09-07, an empty correction array, an empty deliberation string and historical original-table checks do not become current reading, completed content review or a subclaim score.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: A subclaim score, status and axes, external details of historical checks and new corrections are unverified.
- Required materials and conditions: Parent C46, subclaim C, axes and correction history
- Materials to obtain first: A subclaim score, status and axes, external details of historical checks and new corrections are unverified.
- Further research: Material needed: A subclaim score, status and axes, external details of historical checks and new corrections are unverified. This records needed materials; no new research was executed.
- Conditions for verification: Material for Parent C46, subclaim C, axes and correction history must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Parent C46, subclaim C, axes and correction history with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01, S02

### N28 · What was actually read, and which materials are needed for updates?

Verification status: Partly verified  
Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread

- Current findings: Core results and supporting bibliography in the stored summary were used. The two original PubMed URLs are retained; abstracts, full texts, registration, protocols, SAPs, support and COI are unread and access was not attempted. A URL alone does not upgrade reading or verification status.
- Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.
- Reason for missing information: External acquisition, reading, address verification, content review and needed original materials remain outstanding. Updates must preserve complete prior texts/materials, condition versions, separate application records and change history.
- Required materials and conditions: Stored summary, unread external materials and follow-up sources
- Materials to obtain first: External acquisition, reading, address verification, content review and needed original materials remain outstanding. Updates must preserve complete prior texts/materials, condition versions, separate application records and change history.
- Further research: Material needed: External acquisition, reading, address verification, content review and needed original materials remain outstanding. Updates must preserve complete prior texts/materials, condition versions, separate application records and change history. This records needed materials; no new research was executed.
- Conditions for verification: Material for Stored summary, unread external materials and follow-up sources must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual comparator and denominators, distinguishing unread external material.
- Why this condition is needed: This condition connects Stored summary, unread external materials and follow-up sources with sleep-onset latency after a long bath, active shower control, exposure versus outcome duration, crossover order, selected nights, sleep onset versus efficiency/subjective measures, denominators and harms.
- Application exceptions: Preserve original numbers, ±, P values and study exposure only. Distinguish mean bath exposure of 16.1 minutes from short-bath mean sleep onset of 16.1 minutes, active shower control from no heating, simple mean differences from within-person adjusted effects, one selected night from the operational period, sleep onset from efficiency/subjective quality, and the core report from supporting bibliography/unlinked mentions. No new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, bathing/sleep methods, treatment or procedure instructions are created.
- Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.
- Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.
- Related sources: S01, S02

## Evidence and sources

### S01

Maeda T et al. 2023

[PubMed](https://pubmed.ncbi.nlm.nih.gov/37684642/)

Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread without access attempts  
Findings recorded in the summary: Long-bath SOL 12.3 versus shower 20.3 minutes, P<.05; sleep efficiency null  
Record level: Preserved core results from 23 adults, approximately three weeks, three conditions and one selected night per condition. Distinguish active shower control, sleep-onset signals, null objective SE and perceived quality. Condition denominators, within-person estimands, exact CIs, meaning of ± and prior hierarchy are unverified.  
Independent replication: Core S01 Maeda 2023 crossover trial and supporting S02 Dorsey 1996 bibliography differ in population, exposure, timing and directness. The parent and two subclaim sheets share the same stored context. The two older nine-person experiments mentioned in the text are not fully mapped one-to-one to the two current citations. Core 23, supporting nine, another unlinked nine, selected nights and two sheets are not added as unique trials, participants or independent replications; confirmed totals are unrecorded.

| Material | Public availability | Access status | Actually read | Notes |
|---|---|---|---|---|
| Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | Original PubMed URL, PMID 37684642, PMCID PMC10486043 and DOI 10.1186/s40101-023-00337-0 are preserved. The original evidence row lacks a registration key and its citation lacks a registration number. Identifiers/URLs alone do not certify acquisition, reading, prior plans or condition fulfillment; new full-text/registration URLs are not inferred. |
| External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 37684642, PMCID PMC10486043 and DOI 10.1186/s40101-023-00337-0 are preserved. The original evidence row lacks a registration key and its citation lacks a registration number. Identifiers/URLs alone do not certify acquisition, reading, prior plans or condition fulfillment; new full-text/registration URLs are not inferred. |
| Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 37684642, PMCID PMC10486043 and DOI 10.1186/s40101-023-00337-0 are preserved. The original evidence row lacks a registration key and its citation lacks a registration number. Identifiers/URLs alone do not certify acquisition, reading, prior plans or condition fulfillment; new full-text/registration URLs are not inferred. |
| Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 37684642, PMCID PMC10486043 and DOI 10.1186/s40101-023-00337-0 are preserved. The original evidence row lacks a registration key and its citation lacks a registration number. Identifiers/URLs alone do not certify acquisition, reading, prior plans or condition fulfillment; new full-text/registration URLs are not inferred. |
| Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 37684642, PMCID PMC10486043 and DOI 10.1186/s40101-023-00337-0 are preserved. The original evidence row lacks a registration key and its citation lacks a registration number. Identifiers/URLs alone do not certify acquisition, reading, prior plans or condition fulfillment; new full-text/registration URLs are not inferred. |
| Funding, product-support and COI material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 37684642, PMCID PMC10486043 and DOI 10.1186/s40101-023-00337-0 are preserved. The original evidence row lacks a registration key and its citation lacks a registration number. Identifiers/URLs alone do not certify acquisition, reading, prior plans or condition fulfillment; new full-text/registration URLs are not inferred. |

### S02

Dorsey CM et al. 1996

[PubMed](https://pubmed.ncbi.nlm.nih.gov/8736588/)

Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread without access attempts  
Findings recorded in the summary: The original citation historically states that a supporting direction in older women with insomnia was checked. This does not establish current external abstract reading or a newly verified effect.  
Record level: Original citation wording of nine participants, older women with insomnia and historical abstract checking is supporting context different from the core 23-person conditions. Exact exposure, timing, SOL effects, CIs and denominators are unverified. Exact correspondence with another nine-person experiment, healthy women or 30 minutes before bed mentioned in the text is also unlinked; no new report is created.  
Independent replication: Core S01 Maeda 2023 crossover trial and supporting S02 Dorsey 1996 bibliography differ in population, exposure, timing and directness. The parent and two subclaim sheets share the same stored context. The two older nine-person experiments mentioned in the text are not fully mapped one-to-one to the two current citations. Core 23, supporting nine, another unlinked nine, selected nights and two sheets are not added as unique trials, participants or independent replications; confirmed totals are unrecorded.

| Material | Public availability | Access status | Actually read | Notes |
|---|---|---|---|---|
| Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | Original PubMed URL, PMID 8736588, DOI 10.1177/089198879600900203 and unrecorded PMCID/registration number are preserved. Historical abstract checking is not inherited as current reading; core exposure or details of another unlinked report are not filled from this bibliography. |
| External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 8736588, DOI 10.1177/089198879600900203 and unrecorded PMCID/registration number are preserved. Historical abstract checking is not inherited as current reading; core exposure or details of another unlinked report are not filled from this bibliography. |
| Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 8736588, DOI 10.1177/089198879600900203 and unrecorded PMCID/registration number are preserved. Historical abstract checking is not inherited as current reading; core exposure or details of another unlinked report are not filled from this bibliography. |
| Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 8736588, DOI 10.1177/089198879600900203 and unrecorded PMCID/registration number are preserved. Historical abstract checking is not inherited as current reading; core exposure or details of another unlinked report are not filled from this bibliography. |
| Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 8736588, DOI 10.1177/089198879600900203 and unrecorded PMCID/registration number are preserved. Historical abstract checking is not inherited as current reading; core exposure or details of another unlinked report are not filled from this bibliography. |
| Funding, product-support and COI material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Original PubMed URL, PMID 8736588, DOI 10.1177/089198879600900203 and unrecorded PMCID/registration number are preserved. Historical abstract checking is not inherited as current reading; core exposure or details of another unlinked report are not filled from this bibliography. |

## Review criteria and methods

These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score.

- M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Preserved method HTML copies; no current method-content re-review or official tool execution
- M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Preserved method HTML copies; no current method-content re-review or official tool execution
- M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Preserved method HTML copies; no current method-content re-review or official tool execution
- M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Preserved method HTML copies; no current method-content re-review or official tool execution
- M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Preserved method HTML copies; no current method-content re-review or official tool execution

## What the statuses mean

- Met: A state used when required evidence is confirmed after user review. This production does not declare that review complete.
- Partly verified: Some information in the stored summary is linked into the table. External comparison/content review is not complete.
- Unverified: The article leaves this unverified, or required material is absent from the current stored summary. This is distinct from zero, absence or safety.
- Review incomplete: User review pending.
- Not reported: Not reported within the stored material actually read; not extended to the entire primary paper.
- Inaccessible: Means an actual access failure. Access not attempted here is not assigned this state.
- Not applicable: Not used as a substitute for an evidence gap.
- Conflicting data: Requires an observed disagreement under the same comparison criteria; not automatically judged in this production.
- Insufficient evidence for the conditions: Marks a gap in additional material required by the selected conditions; not a new efficacy grade.

## Change history

2026-10-16 · Public page/materials 1.0. Public reader pages and material were prepared from the existing 28 items. No new clinical searches, verification-state changes or scoring were performed.