在临床实践中影响慢性失眠数字认知行为疗法的有效性的因素
Yuan Shi1, Rong Ren1, Ye Zhang1
1Sleep Medicine Center, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
Journal of sleep research
|October 28, 2023
概括
慢性失眠的数字认知行为疗法 (D-CBT-I) 是有效的,但缓解程度有所不同. 较轻微的失眠和更严重的抑郁症预测了更好的结果,而早上醒来和更严重的失眠可能需要更多的支持.
科学领域:
- 精神病学是一个精神病学.
- 睡眠医学 睡眠医学
- 数字健康数字健康
背景情况:
- 针对失眠的数字认知行为疗法 (D-CBT-I) 的疗效与传统的CBT-I相提并论.
- 然而,并非所有患者在D-CBT-I治疗后都能完全缓解失眠.
研究的目的:
- 在现实临床环境中调查影响D-CBT-I有效性的因素.
- 确定与缓解和对D-CBT-I的反应相关的基线特征.
主要方法:
- 一项为期6周的D-CBT-I干预治疗对414名患有慢性失眠的亚洲成年人进行.
- 患者在基线和治疗后被评估,使用失眠严重程度指数 (ISI) 和患者健康问卷-9 (PHQ-9).
- 治疗后确定了缓解 (ISI < 8) 和响应 (ISI 减少 ≥ 8).
主要成果:
- 近一半 (46.4%) 的患者实现了缓解,52.7%的患者表现出反应.
- 较高的基线早晨起床时间和ISI分数与更低的缓解几率有关.
- 升高的基线PHQ-9得分与更高的治疗反应概率有关.
结论:
- D-CBT-I是建议的慢性失眠的第一线治疗方法,特别是对于那些症状较轻和同时出现抑郁症的人来说.
- 较长的清晨清醒时间和在基线时更大的失眠严重程度可能需要加强干预或传统的CBT-I以获得最佳结果.
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