Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, part I: Sleep and psychological effects.
Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, part I: Sleep and psychological effects.
复制标题
认知行为疗法对乳腺癌继发性失眠疗效的随机研究，第一部分：睡眠和心理影响。
DOI：
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发表时间：
2005
影响因子：
45.3
通讯作者：
C. Morin
中科院分区：
文献类型：
--
作者：
J. Savard;S. Simard;H. Ivers;C. Morin
目的
慢性失眠在癌症患者中非常普遍。认知行为疗法（CBT）被认为是治疗慢性原发性失眠的首选。然而，尚未对其治疗癌症继发性失眠的疗效进行随机对照研究。使用随机对照设计，在乳腺癌幸存者中进行的这项研究评估了CBT对睡眠的影响，主观和客观评估，以及催眠药物的使用，心理困扰和生活质量。
患者和方法
57名因乳腺癌引起或加重失眠的女性被随机分配到CBT组（n = 27）或等候名单对照组（n = 30）。治疗包括每周8次的治疗，并结合使用刺激控制、睡眠限制、认知治疗、睡眠卫生和疲劳管理。在治疗后3、6和12个月进行随访评估。
结果
与等待期后的对照组参与者相比，接受失眠治疗的参与者在治疗后的主观睡眠指数（每日睡眠日记，失眠严重程度指数）显着更好，药物治疗的频率更低，抑郁和焦虑水平更低，整体生活质量更高。多导睡眠图指标的结果更加模棱两可。治疗效果在干预后12个月内保持良好，通常具有临床意义。
结论
这项研究支持CBT对继发于乳腺癌的失眠的疗效。
PURPOSE
Chronic insomnia is highly prevalent in cancer patients. Cognitive-behavioral therapy (CBT) is considered the treatment of choice for chronic primary insomnia. However, no randomized controlled study has been conducted on its efficacy for insomnia secondary to cancer. Using a randomized controlled design, this study conducted among breast cancer survivors evaluated the effect of CBT on sleep, assessed both subjectively and objectively, and on hypnotic medication use, psychological distress, and quality of life.
PATIENTS AND METHODS
Fifty-seven women with insomnia caused or aggravated by breast cancer were randomly assigned to CBT (n = 27) or a waiting-list control condition (n = 30). The treatment consisted of eight weekly sessions administered in a group and combined the use of stimulus control, sleep restriction, cognitive therapy, sleep hygiene, and fatigue management. Follow-up evaluations were carried out 3, 6, and 12 months after the treatment.
RESULTS
Participants who received the insomnia treatment had significantly better subjective sleep indices (daily sleep diary, Insomnia Severity Index), a lower frequency of medicated nights, lower levels of depression and anxiety, and greater global quality of life at post-treatment compared with participants of the control group after their waiting period. Results were more equivocal on polysomnographic indices. Therapeutic effects were well maintained up to 12 months after the intervention and generally were clinically significant.
CONCLUSION
This study supports the efficacy of CBT for insomnia secondary to breast cancer.
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DOI：
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