治疗慢性原发性失眠的认知行为疗法:一个随机对照试验
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
概括
认知行为疗法 (CBT) 有效地治疗慢性睡眠维护失眠,显示出睡眠质量和持续时间的显著改善. 这种行为疗法为那些与持续的失眠症状作斗争的人提供了持久的好处.
科学领域:
- 行为科学 行为科学
- 睡眠医学 睡眠医学
- 临床心理学 临床心理学
背景情况:
- 慢性原发性失眠,特别是睡眠维持性失眠,缺乏足够的证据,来自对非药物行为疗法的盲目,安慰剂对照试验.
- 现有的研究还没有明确证明行为干预措施改善睡眠维持的有效性.
研究的目的:
- 为了评估一种混合认知行为疗法 (CBT) 对初级睡眠维护失眠的有效性.
- 将CBT与第一代行为治疗 (渐进性肌肉放松) 和安慰剂治疗进行比较.
主要方法:
- 一项随机,双盲,安慰剂对照试验与75名被诊断为慢性初级睡眠维护失眠的成年人进行.
- 参与者接受CBT,渐进性肌肉放松 (RT) 或安慰剂治疗6周,随访6个月.
- 评估结果使用了多睡眠记录,睡眠日志和测量睡眠参数,自我效能和情绪的问卷.
主要成果:
- 认知行为疗法 (CBT) 在大多数结局指标中,与渐进肌肉放松 (RT) 和安慰剂治疗相比,表现出更高的疗效.
- CBT显著减少了睡眠开始后的觉醒时间 (WASO) 54%,相比之下,RT的16%和安慰剂的12%.
- 接受CBT的患者经历了正常化的睡眠模式,睡眠时间超过6小时,WASO减少和睡眠效率提高,在6个月的随访中持续.
结论:
- 认知行为疗法 (CBT) 是一种可行且有效的治疗初级睡眠维护失眠的干预方法.
- 在6周的治疗期内,CBT会导致临床显著的睡眠改善.
- CBT对睡眠的积极影响似乎是持久的,持续了6个月的随访.
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