对于癌症患者失眠的认知行为疗法
Zhaolun Cai1,2, Yiguo Tang3, Chunyu Liu4
1Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
The Cochrane database of systematic reviews
|October 31, 2025
概括
针对失眠的认知行为疗法 (CBT-I) 可能会对癌症患者的失眠严重程度和睡眠质量略有改善. 然而,证据的确定性低至非常低,对客观睡眠指标的益处尚不清楚.
科学领域:
- 在瘤学瘤学.
- 睡眠医学 睡眠医学
- 精神病学是一个精神病学.
背景情况:
- 失眠是癌症患者常见和令人痛苦的问题,影响了他们的福祉.
- 失眠的认知行为疗法 (CBT-I) 是失眠的标准治疗方法,但需要对癌症患者进行评估.
- 以前的元分析存在局限性,需要对随机对照试验 (RCT) 进行更新的综合分析.
研究的目的:
- 评估认知行为治疗失眠 (CBT-I) 对被诊断患有失眠和癌症的个体的影响.
- 综合RCT的研究结果,将CBT-I与该群体的其他治疗方法进行比较.
主要方法:
- 在多个数据库 (CENTRAL,MEDLINE,Embase,CINAHL,PsycINFO) 和临床试验注册表中进行系统搜索.
- 包括21个随机试验和2431名随机参与者,他们被诊断患有癌症和失眠.
- 随机效应元分析用于初级分析,评估失眠严重程度 (ISI),睡眠质量 (PSQI) 和严重不良事件 (SAE).
主要成果:
- 与非活性对照组相比,CBT-I可能会在失眠严重程度 (ISI) 和睡眠质量 (PSQI) 上提供微小的主观改善 (非常低至低确定性证据).
- 观察到可能减少睡眠开始延迟 (SOL) 和睡眠开始后醒来 (WASO),睡眠效率 (SE) 略有改善.
- 对客观睡眠测量和严重不良事件的益处不太清楚,证据确定性非常低.
结论:
- 在癌症幸存者中,CBT-I可能对失眠提供了小的主观益处,但证据确定性大多是低至非常低的.
- 对有氧活动的有效性表明可能改善失眠严重程度和睡眠质量,尽管证据的确定性很低.
- 需要进一步的大规模,严格和包容性研究来证实CBT-I在癌症患者的长期益处和最佳使用.
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