高齢期の不眠症に対する行動療法および薬理療法:ランダム化制御試験
C M Morin1, C Colecchi, J Stone
1Université Laval, Ecole de Psychologie, Sainte-Foy, Quebec, Canada. cmorin@psy.ulaval.ca
JAMA
|March 23, 1999
まとめ
認知行動療法 (Cognitive-behavioral therapy) は,単独または薬剤と併用して,高齢者の不眠症を効果的に治療します. 行動的アプローチは,薬剤のみと比較して,時間の経過とともに持続的な睡眠改善を提供します.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- スリープ・メディシン (睡眠医学)
- 臨床心理学の臨床心理学について
背景:
- 不眠症は高齢者にとって一般的な問題であり,生活の質に影響を及ぼします.
- 行動療法や薬理療法などの現在の治療法は,メリットとデメリットがあります.
- 以前の研究では,高齢者の不眠症に対するこれらの治療法,個別および併用を直接比較した研究はありませんでした.
研究 の 目的:
- 高齢者の不眠症に対する認知行動療法 (CBT) と薬物療法の効果を,別々に,または併せて評価する.
- これらの介入をプラセボ対照群と比較するために.
主な方法:
- ランダム化,プラセボ対照試験は8週間にわたって実施され,フォローアップは3,12,24ヶ月に行われました.
- 慢性原発性不眠症を有する78人の成人 (平均年齢65歳) が参加した.
- 介入には,CBT,テマゼパム (薬物療法),CBTとテマゼパムの両方,またはプラセボが含まれていました.
主要な成果:
- すべての活性治療は短期的にプラセボを上回った.
- CBTと薬物療法の併用アプローチは,単独の治療よりも睡眠を改善する傾向を示しました.
- 認知行動療法 (Cognitive-Behavior Therapy) は,単独でも,併用でも,参加者と臨床医によって,より効果的で満足度が高いと評価され,フォローアップで持続的な改善が見られた.
結論:
- 行動療法と薬理学的治療の両方が,晩年の不眠症に短期的な救済を提供します.
- 行動療法による治療は,薬剤療法のみと比較して,睡眠改善の長期間維持に優れていることを示しています.
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