Cognitive behavioral therapy for chronic insomnia in occupational health services: Analyses of outcomes up to 24 months post-treatment
Cognitive behavioral therapy for chronic insomnia in occupational health services: Analyses of outcomes up to 24 months post-treatment
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DOI：
10.1016/j.brat.2014.02.007
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发表时间：
2014-05-01
影响因子：
4.1
通讯作者：
Hublin, Christer
中科院分区：
文献类型：
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作者：
Jarnefelt, Heli;Sallinen, Mikael;Hublin, Christer
目的：失眠认知行为疗法（CBT-I）是治疗持续性失眠的有效方法。本研究的目的是探讨CBT-I的有效性和响应模式，白天和轮班工人失眠超过24个月的后续在职业健康服务（OHS）。方法：参与者是59名媒体工作者慢性失眠，其中69%达到24个月的后续行动。睡眠日记和七个测量点的问卷调查被用作结果。训练有素的OHS护士领导CBT-I小组。该研究设计是一个非随机分组intervention.Results：自我感觉的严重程度失眠，睡眠相关的认知功能障碍，精神症状，特别是在24个月的随访显示出改善。工作时间的安排并不影响结果。基于Inflammatory严重指数（ISI），62%的参与者表现出温和的改善CBT-I后，而其余的参与者表现出只有轻微的improvementation.Conclusions：我们的研究结果表明，CBT-I提供的OHS导致长期改善白天和轮班工人。根据失眠的改善程度确定了两组;一组包括三分之二的中度反应参与者，另一组包括三分之一的中度反应参与者。结果需要谨慎解释，因为失眠是轻度的（ISI在所有测量点平均低于15分），样本中的改善相对较小，并且研究设计是非随机的。(C)2014爱思唯尔有限公司版权所有。
Objective: Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment for persistent insomnia. The purpose of this study was to examine the effectiveness of and response patterns to CBT-I among daytime and shift workers with insomnia over a 24-month follow-up in occupational health services (OHS).Methods: The participants were 59 media workers with chronic insomnia, of whom 69% were reached at 24-month follow-up. Sleep diaries and questionnaires over seven measurement points were used as outcomes. Trained OHS nurses led the CBT-I groups. The study design was a non-randomized group intervention.Results: Self-perceived severity of insomnia, sleep-related dysfunctional cognitions, and psychiatric symptoms in particular showed improvements over a 24-month follow-up. Working hour arrangements did not affect the results. Based on the Insomnia Severity Index (ISI), 62% of the participants showed a moderate improvement after CBT-I, whereas the remaining participants showed only a minor improvement.Conclusions: Our results indicate that CBT-I delivered by OHS leads to long-term improvements among both daytime and shift workers. Two groups were identified according to the degree of improvement of insomnia; one comprising two thirds of the participants with a moderate response and the other comprising one thirds of the participants with a modest response. The results need to be interpreted cautiously as insomnia was mild (ISI was on average under 15 points at all measurement points) and improvements were relatively small in the sample, and the study design was non-randomized. (C) 2014 Elsevier Ltd. All rights reserved.