Digital Cognitive Behavioral Therapy for Insomnia in Women With Chronic Migraines
Digital Cognitive Behavioral Therapy for Insomnia in Women With Chronic Migraines
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DOI：
10.1111/head.13777
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发表时间：
2020-02-28
期刊：
影响因子：
5
通讯作者：
Ong, Jason C.
中科院分区：
文献类型：
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作者：
Crawford, Megan R.;Luik, Annemarie I.;Ong, Jason C.
目的/背景失眠通常与慢性偏头痛(CM)并存。CM患者失眠的非药物治疗仍未得到充分研究。这是一项概念验证研究，旨在评估美国CM和失眠(CM-I)患者数字认知行为疗法(dCBT-I)的可行性、可接受性和初步疗效。方法我们从美国的观察队列和普通人群中招募了42名有CM-I症状的女性。在多基线设计中，参与者在完成基线睡眠日记2、4或6周后随机接受dCBT-I。根据完成率(完成dCBT-I=90%)、可接受性(>；=80%，发现dCBT-I可接受)和治疗后失眠症状的变化(>；=50%，表明他们的失眠症状有临床相关的改善)的基准对DCBT-I进行仔细检查。作为第二项指标，我们还报告了发作性偏头痛患者恢复的百分比。结果在42名随机抽样的患者中，35名(83.3%)在所提供的12周内完成了dCBT-I。在这些完成者中，33人(94.3%)报告对治疗感到满意(n=16)或非常满意(n=17)。此外，65.7%的患者根据普遍接受的失眠标准对治疗做出了回应。最后，34%的患者从CM转为发作性偏头痛。结论本研究为DCBT-I在CM-I主诉患者中应用的可行性和可接受性提供了证据。提出了改善失眠和偏头痛的效果。这些结果表明，需要一项随机对照试验来确定dCBT-I对CM患者的疗效。
Objective/Background Insomnia commonly co-occurs with chronic migraines (CM). Non-pharmacological treatments for insomnia in CM patients remain understudied. This is a proof-of-concept study, which aims to evaluate the feasibility, acceptability, and preliminary efficacy of a digital cognitive behavioral therapy for insomnia (dCBT-I) for individuals with CM and insomnia (CM-I) in the United States.Methods We recruited 42 females with CM-I symptoms from a U.S.-based observational cohort and from the general population via advertisements. Within a multiple baseline design, participants were randomized to receive dCBT-I after 2, 4, or 6 weeks of completing baseline sleep diaries. DCBT-I was scrutinized against benchmarks for completion rates (>= 90% to complete dCBT-I), acceptability (>= 80% to find dCBT-I acceptable), and posttreatment changes in insomnia symptoms (>= 50% indicating a clinically relevant improvement in their insomnia symptoms). As a secondary measure, we also reported percentage of individuals reverting to episodic migraines.Results Out of 42 randomized, 35 (83.3%) completed dCBT-I within the 12 weeks provided. Of these completers, 33 (94.3%) reported being satisfied (n = 16) or very satisfied (n = 17) with treatment. Additionally, 65.7% of completers responded to treatment as per universally accepted criteria for insomnia. Lastly, 34% of completers reverted from CM to episodic migraine.Conclusion This study provides evidence for the feasibility and acceptability of dCBT-I in patients with CM-I complaints. Effects of improving insomnia and migraines were suggested. These results indicate that a randomized controlled trial is needed to determine the efficacy of dCBT-I in CM patients.