Do treatment effects of a web-based cognitive behavioral therapy for insomnia intervention differ for users with and without pain interference? A secondary data analysis.
Do treatment effects of a web-based cognitive behavioral therapy for insomnia intervention differ for users with and without pain interference? A secondary data analysis.
复制标题
基于网络的认知行为疗法对失眠干预的治疗效果对于有或没有疼痛干扰的用户是否有所不同？
DOI：
10.1007/s10865-019-00065-w
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发表时间：
2020
影响因子：
3.1
通讯作者：
Ritterband,LeeM
中科院分区：
文献类型：
--
作者：
Shaffer,KellyM;Camacho,Fabian;Lord,HollyR;Chow,PhilipI;Palermo,Tonya;Law,Emily;Thorndike,FrancesP;Ingersoll,KarenS;Ritterband,LeeM
失眠症的认知行为疗法（CBT-I）在疼痛干扰的个体中显示出治疗益处;然而，互联网提供的CBT-I对这一人群的影响尚不清楚。这项二次分析使用了来自被分配到互联网交付CBT-I的成人的随机临床试验数据，以比较干预前疼痛干扰的睡眠变化。参与者（N= 151）在基线、评估后、6个月和12个月随访时完成了失眠严重程度指数（ISI）和睡眠日记[入睡潜伏期（SOL）;入睡后觉醒（WASO）]。线性混合效应模型显示疼痛干预组（无、部分、中度/重度）之间ISI（p= .72）或WASO（p= .88）从基线到任何随访时间点的变化无差异。报告有疼痛干扰的患者与报告无或中度/重度疼痛干扰的患者之间的SOL差异较小（p= .04）。对于那些有和没有疼痛干扰的人来说，主要是可比的和持续的治疗益处表明，互联网提供的CBT-I有望为患有共病疼痛和失眠的个人提供可获得的护理。
Cognitive-behavioral therapy for insomnia (CBT-I) shows treatment benefits among individuals with pain interference; however, effects of Internet-delivered CBT-I for this population are unknown. This secondary analysis used randomized clinical trial data from adults assigned to Internet-delivered CBT-I to compare changes in sleep by pre-intervention pain interference. Participants (N= 151) completed the Insomnia Severity Index (ISI) and sleep diaries [sleep onset latency (SOL); wake after sleep onset (WASO)] at baseline, post-assessment, 6- and 12-month follow-ups. Linear mixed-effects models showed no differences between pain interference groups (no, some, moderate/severe) for changes from baseline to any follow-up timepoint for ISI (p= .72) or WASO (p= .88). There was a small difference in SOL between those reporting some versus no or moderate/severe pain interference (p= .04). Predominantly comparable and sustained treatment benefits for both those with and without pain interference suggest that Internet-delivered CBT-I is promising for delivering accessible care to individuals with comorbid pain and insomnia.