A primary care "friendly" cognitive behavioral insomnia therapy
A primary care "friendly" cognitive behavioral insomnia therapy
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DOI：
10.1093/sleep/26.2.177
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发表时间：
2003-03-15
期刊：
影响因子：
5.6
通讯作者：
Sampson, WS
中科院分区：
文献类型：
--
作者：
Edinger, JD;Sampson, WS
目的：本研究旨在测试简化认知-行为失眠疗法(ACBT)对初级保健患者的有效性。设计：采用单盲随机分组设计，患者被随机分为两个疗程的短期ACBT或类似的短期干预(SHC)，地点：一所大学附属的退伍军人事务部医学中心。参与者：20名(2名女性)退伍军人患者(年龄=51.0岁)。测量和结果：参与者在治疗前、治疗后2周的评估中和治疗后3个月的随访中，完成了为期2周的睡眠记录和问卷调查，以测量失眠症状、睡眠相关的自我效能和对睡眠的功能障碍信念，统计分析显示，在大多数结果指标上，ACBT的改善幅度明显大于SHC。逐个病例的分析表明，只有ACBT在研究患者中产生了一致的积极效果，接受这种治疗的患者中有相当大一部分通过他们的研究终点在临床上取得了显著改善。在接受ACBT治疗的患者中，大约52%的人报告说他们开始睡眠后的觉醒时间至少减少了50%，55.6%的接受ACBT治疗的患者在失眠症状问卷(ISQ)上的病理评分进入研究时，通过最终结果评估获得了正常的ISQ评分。结论：ACBT可以有效地减少初级保健患者的主观睡眠障碍和失眠症状。
Objectives: This study was conducted to test the effectiveness of an abbreviated cognitive-behavioral insomnia therapy (ACBT) with primary care patients.Design: A single-blind, randomized group design was used in which study patients were randomized to either a brief, 2-session ACBT or a similarly brief intervention (SHC) that included only generic sleep hygiene recommendations,Setting: A university-affiliated Department of Veterans Affairs medical center.Participants: Twenty (2 women) veteran patients (M-age = 51.0 yrs., SD = 13.7 years) who met criteria for chronic primary insomnia.Measurements and Results: Participants completed sleep logs for 2 weeks and questionnaires to measures insomnia symptoms, sleep-related self-efficacy, and dysfunctional beliefs about sleep before treatment, during a 2-week posttreatment assessment, and again at a 3-month posttreatment follow-up, Statistical analyses showed that ACBT produced significantly larger improvements across a majority of outcome measures than did SHC. Case-by-case analyses showed that only the ACBT produced consistent positive effects across study patients, and a sizeable proportion of these patients receiving this treatment achieved clinically significant improvements by their study endpoints. Approximately 52% of those receiving the ACBT reported at least a 50% reduction in their wake time after sleep onset, and 55.6% of ACBT-treated patients who entered the study with pathologic scores on an Insomnia Symptom Questionnaire (ISQ), achieved normal ISQ scores by their final outcome assessment.Conclusions: ACBT is effective for reducing subjective sleep disturbance and insomnia symptoms in primary care patients.