Placebo-controlled comparison of prazosin and cognitive-behavioral treatments for sleep disturbances in US Military Veterans.
Placebo-controlled comparison of prazosin and cognitive-behavioral treatments for sleep disturbances in US Military Veterans.
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DOI：
10.1016/j.jpsychores.2011.11.010
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发表时间：
2012-02
影响因子：
4.7
通讯作者：
Nofzinger, Eric A.
中科院分区：
文献类型：
--
作者：
Germain, Anne;Richardson, Robin;Moul, Douglas E.;Mammen, Oommen;Haas, Gretchen;Forman, Steven D.;Rode, Noelle;Begley, Amy;Nofzinger, Eric A.
针对失眠和噩梦的药物和认知行为疗法已被证明对患有睡眠主诉并伴有压力相关障碍症状(包括创伤后应激障碍(PTSD))的退伍军人有效，但这两种方法尚未进行直接比较。这项随机对照试验比较了哌唑嗪与行为睡眠干预(BSI)、针对噩梦和失眠的行为睡眠干预(BSI)以及安慰剂药物对照条件对睡眠和白天症状的影响。50名患有慢性睡眠障碍的美国退伍军人(平均年龄40.9岁，SD=13.2岁)被随机分为哌唑嗪(n=18)、BSI(n=17)或安慰剂(n=15)。每次干预持续8周。参与者完成了失眠严重程度、睡眠质量和睡眠障碍的自我报告。在整个干预期间，所有人都写下了睡眠日记。干预前后进行多导睡眠图检查。两个积极治疗组的失眠严重程度和日间创伤后应激障碍症状严重程度都有较大程度的降低。完成积极治疗的人中有61.9%的人睡眠改善，而随机服用安慰剂的人中有25%的人睡眠改善。在这个退伍军人样本中，BSI和哌唑嗪都与显著改善睡眠和减少日间创伤后应激障碍症状有关。以睡眠为重点的治疗可能会增强一线创伤后应激障碍治疗的益处。
Pharmacological and cognitive-behavioral treatments targeting insomnia and nightmares have been shown to be effective in the treatment of military veterans with sleep complaints comorbid with symptoms of stress-related disorders, including Post-Traumatic Stress Disorder (PTSD), but the two approaches have not been directly compared. This randomized controlled trial compared the effects of prazosin vs. a behavioral sleep intervention (BSI), targeting nightmares and insomnia against a placebo pill control condition on sleep and daytime symptoms. Fifty United States military veterans (mean age 40.9 years, SD = 13.2 years) with chronic sleep disturbances were randomized to prazosin (n = 18), BSI (n = 17), or placebo (n = 15). Each intervention lasted eight weeks. Participants completed self-report measures of insomnia severity, sleep quality, and sleep disturbances. All kept a sleep diary throughout the intervention period. Polysomnographic studies were conducted pre- and post-intervention. Both active treatment groups showed greater reductions in insomnia severity and daytime PTSD symptom severity. Sleep improvements were found in 61.9% of those who completed the active treatments and 25% of those randomized to placebo. BSI and prazosin were both associated with significant sleep improvements and reductions in daytime PTSD symptoms in this sample of military veterans. Sleep-focused treatments may enhance the benefits of first-line PTSD treatments.
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影响因子：
10.6
作者：
Germain, A;Nielsen, TA
通讯作者：
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5.6
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作者：
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