心理和药物治疗失眠对白天功能的影响:一项随机临床试验
Charles M Morin1, Si-Jing Chen1,2, Hans Ivers1
1Centre de Recherche CERVO/Brain Research Center, École de Psychologie, Université Laval, Quebec City, Quebec, Canada.
JAMA network open
|December 28, 2023
概括
行为疗法 (BT) 和皮同样改善了白天失眠症状. 第二阶段的治疗进一步增强了白天的功能,对失眠患者来说,12个月的持续效益.
科学领域:
- 睡眠医学 睡眠医学
- 临床心理学 临床心理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 白天功能障碍是寻求失眠治疗的主要驱动因素.
- 改善白天功能和管理非复发性失眠的最佳治疗策略尚不清楚.
研究的目的:
- 为了比较行为疗法 (BT) 和皮作为初始失眠治疗对白天功能的疗效.
- 评估持续性失眠患者第二次治疗的附加益处.
主要方法:
- 一个连续的多重分配随机临床试验,涉及211名患有慢性失眠障碍的成年人.
- 参与者接受了BT或皮作为第一阶段治疗.
- 没有复发的患者进入了第二阶段,接受心理 (BT或认知) 或药物治疗 (zolpidem或trazodone).
主要成果:
- 无论是BT还是皮都显示出抑郁症状,疲劳,功能障碍和心理健康的显著和可比改善.
- 与佐洛皮德姆相比,BT在焦虑症状方面表现出更好的改善.
- 第二阶段治疗提供了额外的好处,特别是对于疲劳,功能障碍和心理健康,特别是当在佐洛皮德姆后开始时.
结论:
- 用BT或皮进行初始治疗有效地改善了白天失眠症状,两者之间没有显著差异.
- 顺序治疗,特别是添加第二种疗法,提供了附加值,并进一步提高了白天的功能.
- 治疗收益在12个月内得到了很好的维持,BT序列显示了持续的额外改善.
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