慢性原発性不眠症の治療のための認知行動療法:ランダム化制御試験
J D Edinger1, W K Wohlgemuth, R A Radtke
1Psychology Service (116B), VA Medical Center, 508 Fulton St, Durham, NC 27705, USA. jack.edinger@duke.edu
JAMA
|April 20, 2001
まとめ
認知行動療法 (CBT) は,慢性睡眠維持不眠症を効果的に治療し,睡眠の質と持続時間の有意な改善を示しています. この行動療法では,持続的な不眠症の症状と闘っている個人に永続的な利点を提供します.
科学分野:
- 行動科学は,行動科学である.
- 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:
- 慢性原発性不眠症,特に睡眠維持不眠症は,非薬理学的行動療法に対する十分に盲検されたプラセボ対照試験から十分な証拠がありません.
- 既存の研究は,睡眠維持を改善するための行動介入の有効性を決定的に実証していない.
研究 の 目的:
- 主要睡眠維持不眠症に対するハイブリッド認知行動療法 (CBT) の有効性を評価する.
- CBTを第1世代の行動療法 (漸進的な筋肉のリラックス) とプラセボ療法と比較するために.
主な方法:
- ランダム化,ダブルブラインド,プラセボ対照試験は,慢性原発睡眠維持不眠症と診断された75人の成人を対象に実施されました.
- 参加者は,CBT,漸進的な筋リラクゼーション (RT),またはプラセボ治療を6週間受け,フォローアップは6ヶ月でした.
- 結果は,ポリソムノグラフィー,睡眠日記,睡眠パラメータ,自己効能,気分を測定するアンケートを使用して評価されました.
主要な成果:
- 認知行動療法 (Cognitive Behavioral Therapy,CBT) は,進行性筋リラクゼーション (RT) とプラセボ治療と比較して,ほとんどのアウトカム測定において優れた有効性を示した.
- CBTは,睡眠開始後の覚醒時間を (WASO) 54%大幅に短縮し,RTでは16%,プラセボでは12%でした.
- CBTを受けた患者は,正常化された睡眠パターンを経験し,6時間以上の睡眠を達成し,WASOが減少し,睡眠効率が向上し,6ヶ月のフォローアップで持続しました.
結論:
- 認知行動療法 (Cognitive Behavioral Therapy,CBT) は,主睡眠維持不眠症に対する実行可能で効果的な介入です.
- CBTは,6週間の治療期間内に臨床的に有意な睡眠改善につながります.
- 睡眠に対するCBTのポジティブな効果は,持続性があり,6ヶ月の追跡期間中に持続するようです.
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