RECENT ADVANCES IN THE ASSESSMENT AND TREATMENT OF INSOMNIA
RECENT ADVANCES IN THE ASSESSMENT AND TREATMENT OF INSOMNIA
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DOI：
10.1037/0022-006x.60.4.586
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发表时间：
1992-08-01
影响因子：
5.9
通讯作者：
MORIN, CM
中科院分区：
文献类型：
--
作者：
LACKS, P;MORIN, CM
持续性失眠有多种潜在原因，如医学，药理学，生活方式，个性和行为因素。虽然许多睡眠不好的人使用催眠药物，但有大量的认知行为干预措施可以针对躯体和认知唤醒，功能失调的想法和学习适应不良的深层习惯。过去十年进行的结果研究表明，刺激控制和睡眠限制的单一治疗产生了最好的效果，减少了50- 60%的自我报告的目标投诉。大约一半的失眠症患者表现出可靠的变化，尽管只有大约三分之一的人成为良好的睡眠者。多组分方法提供了相当大的希望，但总体上没有超过与简单的刺激控制所取得的成果。建议的新的追求方向包括：（a）检查更广泛的失眠患者，（B）使用多模式评估和更客观的自我报告的好处验证，（c）针对个人因果和维持因素的治疗研究，以及（d）进一步审查新的干预措施，如睡眠限制和更全面的多方面策略。
Persistent insomnia has multiple potential causes such as medical, pharmacological, life-style, personality, and behavioral factors. Although many poor sleepers use hypnotic medications, a wide army of cognitive-behavioral interventions are available that target somatic and cognitive arousal, dysfunctional thoughts, and learned maladaptive deep habits. Outcome research conducted over the past decade reveals that the single treatments of stimulus control and sleep restriction produced the best results, reducing self-reported target complaints by 50-60%. Approximately half of insomniacs show reliable change although only about one third become good sleepers. Multicomponent methods offer considerable promise but on the whole have not surpassed results achieved with the simpler stimulus control. Recommended new directions of pursuit include (a) examination of a broader range of insomnia sufferers, (b) use of multimodal assessment and more objective verification of self-reported benefits, (c) research on treatments tailored to individual causal and maintaining factors, and (d) further scrutiny of newer interventions like sleep restriction and more comprehensive multifaceted strategies.