Change in Dysfunctional Sleep-Related Beliefs is Associated with Changes in Sleep and Other Health Outcomes Among Older Veterans With Insomnia: Findings From a Randomized Controlled Trial.
Change in Dysfunctional Sleep-Related Beliefs is Associated with Changes in Sleep and Other Health Outcomes Among Older Veterans With Insomnia: Findings From a Randomized Controlled Trial.
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与睡眠相关的功能失调信念的改变与失眠老年退伍军人的睡眠和其他健康结果的变化有关：随机对照试验的结果。
DOI：
10.1093/abm/kaab030
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Alessi,CathyA
中科院分区：
文献类型：
--
作者：
Song,Yeonsu;Kelly,MonicaR;Fung,ConstanceH;Dzierzewski,JosephM;Grinberg,AustinM;Mitchell,MichaelN;Josephson,Karen;Martin,JenniferL;Alessi,CathyA
背景：失眠认知行为疗法（CBTI）的目标是改变功能失调的睡眠相关信念。这些变化对老年人日间功能的影响尚不清楚。目的：我们研究了从cbt前到cbt后睡眠相关信念的变化是否能预测老年人睡眠和其他结果的变化。方法数据包括144名老年失眠症退伍军人，来自CBTI随机对照试验。与睡眠有关的信念用睡眠功能失调信念和态度量表（DBAS-16，子量表：后果、担忧/无助、睡眠期望、药物）进行评估。结果包括睡眠日记变量、活动仪测量的睡眠效率、匹兹堡睡眠质量指数（PSQI）、失眠严重指数（ISI）、Epworth嗜睡量表（ESS）、Flinders疲劳量表（FFS）、患者健康问卷-9和与健康相关的生活质量。分析比较了CBTI和对照组之间DBAS亚量表从基线到治疗后的变化斜率，并评估了DBAS变化与基线到6个月结局变化斜率之间的关系。结果与对照组相比，CBTI组表现出DBAS-Consequences改善与随后PSQI、ISI、ESS和FFS改善之间更强的相关性。CBTI组还显示，dbas -担忧/无助的改善与PSQI、ISI和FFS的后续改善之间存在更强的关联；改善dbas用药和PSQI；dbas -睡眠预期、睡眠后醒来（睡眠日记）和FFS的改善（均p< 0.05）。结论：在老年人中，CBTI显著减少了与睡眠相关的功能失调信念，这预示着睡眠和白天功能的一些结果的改善。这表明解决与睡眠相关的信念对于老年退伍军人的CBTI持续改善的重要性。临床试验注册号：NCT00781963。
BackgroundCognitive behavioral therapy for insomnia (CBTI) targets changing dysfunctional sleep-related beliefs. The impact of these changes on daytime functioning in older adults is unknown.PurposeWe examined whether changes in sleep-related beliefs from pre- to post-CBTI predicted changes in sleep and other outcomes in older adults.MethodData included 144 older veterans with insomnia from a randomized controlled trial testing CBTI. Sleep-related beliefs were assessed with the Dysfunctional Beliefs and Attitudes about Sleep-16 (DBAS-16, subscales: Consequences, Worry/Helplessness, Sleep Expectations, Medication). Outcomes included sleep diary variables, actigraphy-measured sleep efficiency, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Flinders Fatigue Scale (FFS), Patient Health Questionnaire-9, and health-related quality of life. Analyses compared slope of change in DBAS subscales from baseline to posttreatment between CBTI and control, and assessed the relationship between DBAS change and the slope of change in outcomes from baseline to 6 months.ResultsCompared to controls, the CBTI group demonstrated stronger associations between improvement in DBAS-Consequences and subsequent improvement in PSQI, ISI, ESS, and FFS. The CBTI group also demonstrated stronger associations between improvement in DBAS-Worry/Helplessness and subsequent improvements in PSQI, ISI, and FFS; improvements in DBAS-Medication and PSQI; and improvements in DBAS-Sleep Expectations and wake after sleep onset (sleep diary) and FFS (allp< .05).ConclusionsSignificant reduction in dysfunctional sleep-related beliefs following CBTI in older adults predicted improvement in several outcomes of sleep and daytime functioning. This suggests the importance of addressing sleep-related beliefs for sustained improvement with CBTI in older veterans.Trial RegistrationClinicalTrials.gov Identifier: NCT00781963.
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影响因子：
5.6
作者：
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影响因子：
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