Efficacy of a multicomponent psychological intervention for children with insomnia - randomized con-trolled trial including 3 months follow-up

多成分心理干预对失眠儿童的疗效——随机对照试验，包括 3 个月的随访

• 批准号: 230068689
• 负责人: Professorin Dr. Andrea Kübler
• 金额: --
• 依托单位: Abteilung für Psychologie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2013
• 资助国家: 德国
• 起止时间: 2012-12-31 至 2017-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/230068689?language=en
• 关键词: Efficacy; multicomponent; psychological; intervention; children

Approximately 15% of preschool and school children are affected by insomnia. Symptoms are usually difficulties initiating and maintaining sleep. Without treatment, sleep disturbances in early childhood persist in more than 40% of the cases. Consequences of disturbed sleep are daytime sleepiness, im-paired cognitive performance and school problems, internalizing and externalizing behaviour and a higher risk for suicide. Furthermore, the risk increases for adulthood depression and anxiety disorders. For the age group of 5 to 10 years, no manual based psychological treatment, including children and their parents, is available. Therefore, our group developed a non-pharmacological, psychological treatment with cognitive-behavioural, hypnotherapeutic and educational components (KiSS). In a pilot-study this treatment program led to a significantly larger reduction of sleep problems in the treatment group than in the waiting list control group (Schlarb et al., 2011). Based on these preliminary results we now apply for a randomized, controlled, large outcome study and assume that in children (aged 5-10 years) with insomnia the treatment will be superior in reducing sleep problems to psychoeducation (PE) and a waiting list control group (WL). As primary outcome measure, we expect reduced sleep onset latency as measured with actigraphy. As secondary outcome measures we further predict for the treatment group reduced number of night-time awakenings, less night-time fears and bedtime struggles, higher remission rates (short- and long-term), less daytime sleepiness and higher level of attention. Additionally, we predict a significant improvement of parental sleep, psychological wellbeing and a reduction of depressive symptoms, specifically for mothers.

大约15%的学龄前儿童和学龄前儿童受到失眠的影响。症状通常是难以启动和维持睡眠。如果没有治疗，40%以上的儿童早期睡眠障碍会持续存在。睡眠紊乱的后果是白天嗜睡，认知能力受损和学校问题，内化和外化行为以及更高的自杀风险。此外，成年抑郁症和焦虑症的风险增加。对于5至10岁的年龄组，包括儿童及其父母在内，不提供基于手工的心理治疗。因此，我们的小组开发了一种非药物，心理治疗与认知行为，催眠和教育成分（KiSS）。在一项初步研究中，该治疗方案导致治疗组中睡眠问题的减少比等待名单对照组中的睡眠问题的减少显著更大（Schlarb等人，2011年）。基于这些初步结果，我们现在申请进行一项随机、对照、大型结果研究，并假设在失眠儿童（5-10岁）中，治疗在减少睡眠问题方面上级心理教育（PE）和等待名单对照组（WL）。作为主要的结果指标，我们预期通过体动记录仪测量的睡眠起始潜伏期减少。作为次要结局指标，我们进一步预测治疗组的夜间觉醒次数减少，夜间恐惧和睡前挣扎减少，缓解率（短期和长期）更高，白天嗜睡减少，注意力水平更高。此外，我们预测父母的睡眠，心理健康和抑郁症状的减少，特别是母亲的显着改善。