使用数字和面对面的认知行为疗法,在初级保健中逐步治疗失眠:一个务实的非随机临床试验
Charles M Morin1, Si-Jing Chen2, Kathleen Lemieux3
1École de psychologie, Université Laval, 2325 rue des Bibliothèques, Québec, Québec, G1V 0A6, Canada; Centre de recherche CERVO/Brain Research Center, 2301 Av. D'Estimauville, Québec, Québec, G1E 1T2, Canada.
Sleep medicine
|May 15, 2025
概括
使用数字认知行为疗法治疗失眠 (dCBT-I) 的逐步护理模型在初级保健中被证明是有效的. 这种方法,单独或与药物一起使用,与单独使用药物相比,显著改善了失眠症状.
科学领域:
- 睡眠医学 睡眠医学
- 行为科学 行为科学
- 主要护理实践的初级护理实践
背景情况:
- 慢性失眠障碍在初级保健机构中很普遍.
- 目前的治疗方法通常涉及处方睡眠药,效果各不相同.
- 在初级保健中存在需要可访问和有效的失眠干预措施.
研究的目的:
- 在初级保健中评估慢性失眠障碍逐步护理干预措施的有效性.
- 为了比较失眠的数字认知行为疗法 (dCBT-I) 和组合治疗与通常的药物治疗.
- 评估实施CBT-I在逐步护理模式中的可行性和效率.
主要方法:
- 一个非随机的实用临床试验,涉及154名患有慢性失眠障碍的成年人.
- 患者可以选择数字CBT-I (dCBT-I),结合dCBT-I和药物治疗,或者作为第一步单独服用药物治疗.
- 非转发者可以选择面对面的CBT-I (FtFCBT-I),药物治疗或不再接受进一步的治疗.
主要成果:
- 与单独服用药物相比,dCBT-I和联合治疗都显著降低了失眠的严重程度.
- 对dCBT-I (54.8%) 和联合治疗 (53.6%) 和药物治疗 (16.0%) 的反应率显著更高.
- 对dCBT-I (65.8%) 和联合治疗 (67.5%) 和药物治疗 (9.4%) 的缓解率显著更高,在6个月内持续改善.
结论:
- 在初级保健中,数字和面对面的CBT-I在逐步护理模式下是可行的和高效的.
- 这种逐步治疗方法为治疗失眠的药物治疗提供了一个有价值的替代方案.
- 这些发现支持将CBT-I整合到常规初级保健中,以管理慢性失眠障碍.
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