Cognitive behavior therapy for insomnia for untreated hypertension with comorbid insomnia disorder: The SLEEPRIGHT clinical trial.
Cognitive behavior therapy for insomnia for untreated hypertension with comorbid insomnia disorder: The SLEEPRIGHT clinical trial.
复制标题
针对未治疗的高血压合并失眠症的失眠症的认知行为疗法：SLEEPRIGHT 临床试验。
DOI：
10.1111/jch.14763
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Hinderliter,Alan
中科院分区：
文献类型：
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作者：
Sherwood,Andrew;Ulmer,Christi;Wu,JadeQ;Blumenthal,JamesA;Herold,Emma;Smith,PatrickJ;Koch,GaryG;Johnson,Kristy;Viera,Anthony;Edinger,Jack;Hinderliter,Alan
失眠和睡眠不足与心血管疾病（CVD）及其前兆（包括高血压）的风险增加有关。2022年，美国心脏协会（AHA）将睡眠不足添加到增加心血管疾病风险的健康行为清单中。然而，成功治疗失眠和睡眠不足是否可以降低心血管疾病的风险仍然未知。SLEEPRIGHT是一项单中心、前瞻性临床试验，旨在评估失眠的成功治疗是否会改善未经治疗的高血压和共病失眠障碍患者的CVD风险标志物。参与者（N= 150）将接受基线评估，然后是6周的导入期，之后他们将接受失眠症认知行为治疗（CBT-I），包括6周内与经验丰富的CBT-I治疗师进行6小时的治疗。除了失眠严重程度的测量以及睡眠的主观和客观测量外，主要结局指标是夜间血压（BP）和通过24小时动态血压监测（ABPM）评估的BP下降。次要结局包括几种CVD风险生物标志物，包括临床BP、血脂、血管内皮功能、动脉硬度和交感神经系统（SNS）活动。数据分析将评估失眠和睡眠改善与原发性和继发性CVD风险生物标志物结局之间的相关性。SLEEPRIGHT试验（ClinicalTrials.Gov NCT 04009447）将利用CBT‐I（目前治疗失眠症的金标准）来评估降低失眠严重程度和改善睡眠是否伴随着未经治疗的高血压患者CVD风险生物标志物的改善。
Insomnia and poor sleep are associated with an increased risk of developing cardiovascular disease (CVD) and its precursors, including hypertension. In 2022, the American Heart Association (AHA) added inadequate sleep to its list of health behaviors that increase the risk for CVD. It remains unknown, however, whether the successful treatment of insomnia and inadequate sleep can reduce heightened CVD risk. SLEEPRIGHT is a single‐site, prospective clinical trial designed to evaluate whether the successful treatment of insomnia results in improved markers of CVD risk in patients with untreated hypertension and comorbid insomnia disorder. Participants (N= 150) will undergo baseline assessments, followed by a 6‐week run‐in period after which they will receive cognitive behavior therapy for insomnia (CBT‐I), comprised of 6 hourly sessions with an experienced CBT‐I therapist over a 6‐week period. In addition to measures of insomnia severity, as well as both subjective and objective measures of sleep, the primary outcome measures are nighttime blood pressure (BP) and BP dipping assessed by 24‐h ambulatory BP monitoring (ABPM). Secondary outcomes include several CVD risk biomarkers, including clinic BP, lipid profile, vascular endothelial function, arterial stiffness, and sympathetic nervous system (SNS) activity. Data analysis will evaluate the association between improvements in insomnia and sleep with primary and secondary CVD risk biomarker outcomes. The SLEEPRIGHT trial (ClinicalTrials.Gov NCT04009447) will utilize CBT‐I, the current gold standard treatment for insomnia disorder, to evaluate whether reducing insomnia severity and improving sleep are accompanied by improved biomarkers of CVD risk in patients with untreated hypertension.