非药物干预措施缓解一般性焦虑症患者失眠的有效性:系统评估和净元分析
Boyu Zhang1,2, Yiwen Li1, Wenming Chu1,2
1Henan University of Chinese Medicine, Zhengzhou, China.
Frontiers in psychiatry
|November 17, 2025
概括
针和经磁刺激与心理治疗是最有效的非药物干预措施,以改善睡眠和减少焦虑一般性焦虑症患者的焦虑.
科学领域:
- 精神病学是一个精神病学.
- 睡眠医学 睡眠医学
- 补充和替代医学 补充和替代医学
背景情况:
- 通用焦虑症 (GAD) 经常与失眠同时发生.
- 与GAD相关的失眠药物治疗方法的有效性和安全性问题有限.
- 非药理干预措施 (NIP) 是有前途的,但需要进行比较有效性评估.
研究的目的:
- 进行一个网络元分析 (NMA),评估各种NIP对GAD患者失眠的疗效.
- 为了比较14个不同的NIP的相对有效性.
主要方法:
- 在多个数据库中系统地搜索随机对照试验 (RCT) 的文献.
- 使用马尔科夫链蒙特卡洛 (MCMC) 模拟的贝叶斯网络元分析.
- 评估睡眠质量 (PSQI,ISI) 和焦虑症状 (HAMA,SAS).
主要成果:
- 针 (AC) 在改善睡眠质量和减少焦虑方面表现出最高的疗效.
- 经磁刺激与心理治疗 (TMS+PT) 结合,也显著改善了睡眠和焦虑.
- 其他干预措施,如放松和运动治疗,其有效性有限.
结论:
- 针和TMS+PT被确定为在GAD中管理失眠和焦虑的领先NIP.
- 建议进行进一步的多中心试验和机制研究,以验证发现并个性化治疗.
相关概念视频
Management of Insomnia
517
The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
517
Insomnia
385
Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
Multiple factors contribute...
Multiple factors contribute...
385
Sedatives and Hypnotics Drugs: Miscellaneous Agents
490
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
490
Anxiolytic Drugs: Benzodiazepines and Buspirone
2.3K
Benzodiazepines are a class of anxiolytic drugs known for their rapid efficacy and high therapeutic-to-lethal dose ratio, but with a potential risk of drug dependence. These drugs are lipophilic, allowing for rapid absorption after oral administration, eventually reaching the central nervous system (CNS). Once in the CNS, benzodiazepines bind to the allosteric site of the GABAA receptor. This binding enhances the inhibitory effects of the neurotransmitter GABA. By doing so, they prevent...
2.3K
Sedatives and Hypnotics: Overview
1.3K
Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
1.3K
CNS Depressants: Barbiturates and Benzodiazepines
1.1K
CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
1.1K


