Effect of cognitive behavioural therapy for insomnia on sleep architecture and sleep EEG power spectra in psychophysiological insomnia
Effect of cognitive behavioural therapy for insomnia on sleep architecture and sleep EEG power spectra in psychophysiological insomnia
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DOI：
10.1111/j.1365-2869.2004.00431.x
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发表时间：
2004-12-01
影响因子：
4.4
通讯作者：
Besset, A
中科院分区：
文献类型：
--
作者：
Cervena, K;Dauvilliers, Y;Besset, A
现在有压倒性的优势证据表明，失眠的认知行为疗法（CBT-I）是有效的，在急性治疗期间（4-8周）与镇静催眠药一样有效，并且在长期（治疗后）更有效。虽然CBT-I治疗慢性失眠症的疗效是众所周知的，但是关于CBT-I对睡眠结构和睡眠EEG功率密度的影响的客观数据很少。本研究首先评估了睡眠质量和数量的主观变化，其次评估了CBT-I治疗8周后睡眠过程中多导睡眠图和EEG功率密度的变化。9名患有心理生理性失眠的免费药物患者，年龄33-62岁（平均年龄47 +/- 9.7岁），7名女性和2名男性参与了研究。在CBT-I前1周和CBT-I后1周进行自评问卷调查，在CBT-I前1周、CBT-I期间和CBT-I后1周每天填写睡眠日记。受试者在CBT-I之前和之后连续两个多导睡眠图夜晚。在控制清醒16小时后的第二天晚上进行光谱分析。CBT-I后，只有失眠量表显著降低，第2阶段，REM睡眠和SWS持续时间显著增加。慢波活动（SWA）增加，SWA衰减缩短，β和σ活动减少。总之，CBT-I改善了主观和客观的睡眠质量。CBT-I可以增强睡眠压力，改善稳态睡眠调节。
There is now an overwhelming preponderance of evidence that cognitive behavioural therapy for insomnia (CBT-I) is effective, as effective as sedative hypnotics during acute treatment (4-8 weeks), and is more effective in long term (following treatment). Although the efficacy of CBT-I in the treatment of chronic insomnia is well known, however there is little objective data on the effects of CBT-I on sleep architecture and sleep EEG power densities. The present study evaluated, first, subjective change in sleep quality and quantity, and secondly the modifications occurring in polysomnography and EEG power densities during sleep after 8 weeks of CBT-I. Nine free drug patients with psychophysiological insomnia, aged 33-62 years (mean age 47 +/- 9.7 years), seven female and two male participated in the study. Self-report questionnaires were administered 1 week before and 1 week after CBT-I, a sleep diary was completed each day 1 week before CBT-I, during CBT-I and 1 week after CBT-I. Subjects underwent two consecutive polysomnographic nights before and after CBT-I. Spectral analysis was performed the second night following 16 h of controlled wakefulness. After CBT-I, only scales assessing insomnia were significantly decreased, stages 2, REM sleep and SWS durations were significantly increased. Slow wave activity (SWA) was increased and the SWA decay shortened, beta and sigma activity were reduced. In conclusion CBT-I improves both subjective and objective sleep quality of sleep. CBT-I may enhance sleep pressure and improve homeostatic sleep regulation.