Examining sleep over time in a randomized control trial comparing two integrated PTSD and alcohol use disorder treatments.
Examining sleep over time in a randomized control trial comparing two integrated PTSD and alcohol use disorder treatments.
复制标题
DOI：
10.1016/j.drugalcdep.2020.107905
复制
发表时间：
2020-04-01
影响因子：
4.2
通讯作者：
Norman SB
中科院分区：
文献类型：
--
作者：
Colvonen PJ;Straus LD;Drummond SPA;Angkaw AC;Norman SB
失眠与创伤后应激障碍(PTSD)和酒精使用障碍(AUD)高度共存。这是令人担忧的，因为失眠会导致更严重的药物滥用和创伤后应激障碍，以及一系列负面的健康后果。还没有研究追踪睡眠指数和失眠的变化与使用循证暴露疗法的PTSD和AUD综合治疗有关的情况。这项研究在两种PTSD和AUD综合治疗的随机对照试验中，研究了失眠随时间的变化。参与者是119名成年退伍军人(90%为男性)，他们在一家大型城市退伍军人医院寻求AUD和PTSD的治疗。参与者被随机分为COPE(使用长期暴露的综合治疗)或寻求安全(使用认知行为、人际关系技术和病例管理的综合治疗)。在治疗前和治疗后进行评估，包括：临床医生使用创伤后应激障碍量表，时间线追踪日历辅助的AU访谈，失眠严重程度指数(ISI)，睡眠日记和7天的活动记录。ISI显示出显著的下降，但大多数在治疗后仍高于临床临界值。入睡后苏醒时间减少，但仅减少8分钟，仍高于临床阈值。创伤后应激障碍的减少，而不是大量饮酒，预示着ISI的变化。在测量的其他睡眠变量中没有观察到明显的变化。研究结果表明，睡眠质量在统计上有所改善，但睡眠指数仍高于临床临界值。这项研究提供的证据表明，失眠是一种独立的疾病，仅对创伤后应激障碍或AUD治疗无效。患有精神疾病的患者应评估和治疗睡眠症状。
Insomnia is highly co-occurring with both posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). This is concerning since insomnia contributes to worse substance abuse and PTSD, and a host of negative health consequences. No study has tracked how sleep indices and insomnia change related to integrated PTSD and AUD treatment using evidence-based exposure therapy. This study examined how insomnia changes over time in a randomized control trial of two integrated PTSD and AUD treatments. Participants were 119 adult veterans (90% male) seeking treatment for AUD and PTSD at a large urban VA. Participants were randomized to either COPE (integrated treatment using prolonged exposure) or Seeking Safety (integrated therapy using cognitive behavioral, interpersonal techniques and case management). Assessments were done at pre- and post-treatment and include: Clinician Administered PTSD Scale, Timeline Follow-back calendar-assisted interview for AU, insomnia severity index (ISI), sleep diary and actigraphy for 7 days. ISI showed significant decreases, but a majority remained above the clinical cutoff at post-treatment. Wake after sleep onset decreased, but only by 8 minutes, remaining above clinical thresholds. Decreases in PTSD, but not in heavy drinking, predicted change in ISI. No significant changes were observed in other sleep variables measured. Findings suggested some statistical improvements in sleep quality, but sleep indices remained above clinical cut-offs. This study provides evidence that insomnia is an independent disorder and not responsive to PTSD or AUD treatments alone. Sleep symptoms should be assessed and treated in patients with comorbid mental health conditions.
登录
查看更多内容
酒精依赖患者失眠的认知行为疗法：一项随机对照试点试验。
影响因子：
4.1
作者：
Arnedt JT;Conroy DA;Armitage R;Brower KJ
通讯作者：
Brower KJ
与PTSD相关的悖论失眠症：具有慢性PTSD的退伍军人的行为研究。
影响因子：
--
作者：
Ghadami MR;Khaledi-Paveh B;Nasouri M;Khazaie H
通讯作者：
Khazaie H
DOI：
10.1097/01.alc.0000081622.03973.57
发表时间：
2003-08-01
期刊：
ALCOHOL-CLINICAL AND EXPERIMENTAL RESEARCH
影响因子：
--
作者：
Currie, SR;Clark, S;Malhotra, S
通讯作者：
Malhotra, S
影响因子：
6.6
作者：
Franklin, C. Laurel;Raines, Amanda M.;Maieritsch, Kelly P.
通讯作者：
Maieritsch, Kelly P.
影响因子：
4.3
作者：
Colvonen, Peter J.;Masino, Tonya;Norman, Sonya B.
通讯作者：
Norman, Sonya B.