Sleeping well with cancer: a systematic review of cognitive behavioral therapy for insomnia in cancer patients.
Sleeping well with cancer: a systematic review of cognitive behavioral therapy for insomnia in cancer patients.
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DOI：
10.2147/ndt.s47790
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发表时间：
2014
影响因子：
3.2
通讯作者：
Campbell T
中科院分区：
文献类型：
--
作者：
Garland SN;Johnson JA;Savard J;Gehrman P;Perlis M;Carlson L;Campbell T
相对于一般人群，癌症患者受睡眠障碍和失眠的影响不成比例。这些问题可能是癌症诊断和治疗的心理，行为和身体影响的结果。抑郁症通常持续多年，当与已经很高的癌症相关的痛苦相结合时，可能会使癌症幸存者面临更高的未来身心健康问题和更差的生活质量的风险。推荐的失眠症一线治疗是失眠症认知行为疗法（CBT-I），这是一种非药物治疗，结合了认知和行为改变技术，并针对功能失调的态度，信念和涉及睡眠的习惯。本文对CBT-I对癌症患者和幸存者的睡眠和心理结局的疗效进行了全面的文献综述。检索显示了12项研究（4项未对照，8项对照），这些研究评估了CBT-I对癌症患者或幸存者的影响。结果表明，CBT-I与癌症患者主观睡眠结果的统计学和临床显著改善相关。CBT-I还可以改善情绪，疲劳和整体生活质量，并且可以通过各种治疗方式成功交付，从而可以接触到更广泛的患者，这些患者可能无法获得更传统的项目。这一领域的未来研究应侧重于将证据转化为临床实践，以提高人们对癌症护理中有效失眠治疗的认识和获得。
Individuals with cancer are disproportionately affected by sleep disturbance and insomnia relative to the general population. These problems can be a consequence of the psychological, behavioral, and physical effects of a cancer diagnosis and treatment. Insomnia often persists for years and, when combined with already high levels of cancer-related distress, may place cancer survivors at a higher risk of future physical and mental health problems and poorer quality of life. The recommended first-line treatment for insomnia is cognitive behavioral therapy for insomnia (CBT-I), a non-pharmacological treatment that incorporates cognitive and behavior-change techniques and targets dysfunctional attitudes, beliefs, and habits involving sleep. This article presents a comprehensive review of the literature examining the efficacy of CBT-I on sleep and psychological outcomes in cancer patients and survivors. The search revealed 12 studies (four uncontrolled, eight controlled) that evaluated the effects of CBT-I in cancer patients or survivors. Results suggest that CBT-I is associated with statistically and clinically significant improvements in subjective sleep outcomes in patients with cancer. CBT-I may also improve mood, fatigue, and overall quality of life, and can be successfully delivered through a variety of treatment modalities, making it possible to reach a broader range of patients who may not have access to more traditional programs. Future research in this area should focus on the translation of evidence into clinical practice in order to increase awareness and access to effective insomnia treatment in cancer care.