BRIEF BEHAVIORAL TREATMENT OF INSOMNIA IN PRIMARY CARE

老年痴呆症是一种广泛流行的慢性健康问题，与严重的心理、身体和经济后果有关。以前的研究已经证明了原发性失眠的行为治疗的有效性和持久性，但在常规实践环境中，在患有合并症的医学和精神疾病的患者中，以及在简短的治疗形式中，关于其效用的证据较少。本研究的总体目的是比较失眠症的简短行为治疗（BBTI）的疗效与仅信息对照条件下，在初级保健环境中常见的阴道病患者。本研究的具体目标是1。测试BBTI与仅信息对照相比在初级保健环境中改善失眠个体的睡眠和健康结果的短期疗效; 2.测试BBTI在初级保健机构失眠患者中的持久性;以及3.比较有失眠和无失眠的老年人在心理健康、身体健康、睡眠和昼夜节律功能以及一般功能方面的差异。我们还将解决以下全计划的目标：评估身体和心理健康对睡眠的影响以及对睡眠干预的反应，并评估睡眠干预对健康和功能的影响。本研究将在每个随机分配的治疗单元中纳入50例受试者。基线测量将包括计划项目组（ProgramProject Battery）中的每个领域。BBTI专注于睡眠教育，健康的睡眠实践和行为干预，以改善失眠。它由一名护士治疗师在四周的时间间隔内分两次提供，并辅以每周简短的电话。将通过录音带评级监测治疗完整性，并通过睡眠日记监测治疗依从性。的 仅信息控制条件被设计为近似于在医生办公室中可能可用的信息类型，并且将包括向患者提供三个患者小册子，所述患者小册子涉及衰老中的睡眠、失眠和睡眠卫生。短期结果将通过在一个月结束时给予阿托伐他汀来评估，BBTI的持久性将通过在六个月时再次给予阿托伐他汀的临床部分以及在十二个月时再次给予阿托伐他汀的临床和多导睡眠图部分来评估。这项研究代表了一种混合 一个经典的疗效研究，其特征是招募和高度选择的样本与“纯”形式的疾病，和一个有效性研究，与一个大样本的受试者在他们的日常护理设置。

Insomnia is a widely prevalent and typically chronic health problem among the elderly that is associated with significant psychological, physical, and economic consequences. Previous studies have demonstrated the efficacy and durability of behavioral treatments for primary insomnia, but there is less evidence regarding their utility in routine practice settings, in patients with comorbid medical and psychiatric disorders, and in a brief treatment format. The general aim of this study is to compare the efficacy of a brief behavioral treatment for insomnia (BBTI) to an information-only control condition in patients with the usual morbidities of agina seen in primary care settings. Specific aims for this study are 1. To test the short-term efficacy of BBTI versus an information-only control for improving sleep and health outcomes among individuals with insomnia in primary care settings; 2. To test the durability of BBTI among individuals with insomnia in primary care settings; and 3. To compare older adults with and without insomnia in terms of mental health, physical health, sleep and circadian function, and general functioning. We will also address the following Program-wide aim: To evaluate the effects of physical and mental health on sleep and the response to sleep interventions, and to evaluate the effects of sleep interventions on health and functioning. The study will include 50 subjects in each randomly-assigned treatment cell. Baseline measures will include each of the domains in the Program Project battery (Agebat). BBTI focuses on sleep education, healthy sleep practices, and behavioral interventions to improve insomnia. It is delivered in two sessions over a four-week interval by a nurse therapist, supplemented by brief weekly telephone calls. Treatment integrity will be monitored by audiotape ratings, and treatment adherence by sleep diaries. The information-only control condition is designed to approximate the type of information that may be available in a physician's office, and will consist of providing patients with three patient brochures that address sleep in aging, insomnia, and sleep hygiene. Short-term outcome will be assessed by administration of Agebatat the end of one month, and durability of BBTI will be evaluated by readministration of the clinical portions of Agebatat six months, and both clinical and polysomnographic components of Agebat at twelve months. This study represents a hybrid between a classic efficacy study, characterized by recruited and highly selected samples with "pure" forms of a disorder, and an effectiveness study, with a large sample of subjects treated in their usual care setting.