基于正念的干预可以改善慢性失眠障碍的认知行为疗法在一般人群中的结果吗? 系统审查和元分析
Manuel de Entrambasaguas1, Cintia Díaz-Silveira2, Francisco A Burgos-Julián3
1Sleep Unit, Clinical Neurophysiology, Hospital Clínico Universitario de Valencia, Valencia, Spain.
Clinical psychology & psychotherapy
|June 4, 2023
概括
基于正念的干预措施 (MBI) 与失眠的认知行为疗法 (CBT-I) 结合,没有显著改善成年人的失眠障碍. 建议对实用设计进行进一步的研究,以澄清MBI.
科学领域:
- 睡眠医学 睡眠医学
- 心理学 心理学 心理学
- 基于证据的实践.
背景情况:
- 失眠的认知行为疗法 (CBT-I) 是慢性失眠障碍 (ID) 的首要治疗方法.
- 基于正念的干预 (MBI) 越来越多地用于减轻压力,但它们在睡眠障碍中的有效性缺乏强有力的科学支持.
- 慢性失眠症通常与过度兴奋有关.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT) 和非随机研究 (NRS),以评估MBI作为成年失眠CBT-I的组成部分.
- 通过使用标准化结果指标,评估MBI对失眠严重程度和睡眠质量的影响.
主要方法:
- 通过使用PubMed,PsycINFO,Cochrane和Web of Science等数据库进行了RCT和NRS的系统审查和元分析.
- 包括专注于MBIs作为成人失眠CBT-I的一部分的研究.
- 主要结局是失眠严重程度指数 (ISI);次要结局包括匹兹堡睡眠质量指数 (PSQI) 和复合睡眠变量 (CSV).
主要成果:
- 分析包括九项研究 (六项RCT,3项NRS).
- MBIs显示在ISI上几乎显著的小到中效果大小 (p=0.07) 和在CSV上显著的小效果大小 (p<0.01),但在PSQI上非显著的中效果大小 (p=0.18).
- 在一般成年人群中,MBI与CBT-I结合对失眠障碍没有显著的积极影响.
结论:
- 目前的证据不支持MBI作为成年失眠CBT-I的有效组成部分.
- 研究设计的局限性 (缺乏实用设计) 和结果措施可能影响了结果.
- 建议未来的研究采用务实设计和适当的测量工具,以更好地评估睡眠干预中的MBI.
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