Rosen RC, Lewin DS, Goldberg L, Woolfolk RL
Department of Psychiatry and the Sleep Disorders Center, UMDNJ-Robert Wood Johnson Medical School, 675 Hoes Lane, NJ 08854, Piscataway, USA
Sleep Med. 2000 Oct 1;1(4):279-288. doi: 10.1016/s1389-9457(00)00042-3.
Objective: To compare treatment outcomes associated with combined pharmacologic and non-pharmacologic treatments for psychophysiological insomnia.Background: Treatments for insomnia have included a variety of pharmacotherapy and cognitive-behavioral interventions, although few studies have investigated the combined efficacy of drug and non-drug therapy.Methods: Forty-one patients with primary insomnia were randomly assigned to one of three treatment groups: (i) estazolam + muscle relaxation, (ii) estazolam + guided imagery, and (iii) estazolam + sleep education. After 4 weeks of active treatment, subjects were withdrawn from medication and followed for an additional 6 months.Results: Significant improvements were observed in self-report measures of total sleep time, sleep efficiency, and wakefulness after sleep onset in the combined drug and relaxation groups, compared to a significant improvement in total sleep time only in the educational control group. At follow-up, all three groups showed significant improvements across the major sleep measures. Positive changes were also observed in quality of life measures, including mood state and self- ratings of daytime arousal.Conclusions: These findings provide support for the value of combined pharmacotherapy and relaxation training in the treatment of psychophysiological insomnia.
比较药物治疗与非药物治疗相结合对心理生理性失眠的治疗效果。背景：失眠的治疗方法包括多种药物治疗和认知行为干预，尽管很少有研究调查药物治疗和非药物治疗的联合疗效。方法：41例原发性失眠患者被随机分为三个治疗组之一：（i）艾司唑仑+肌肉放松，（ii）艾司唑仑+引导式意象，（iii）艾司唑仑+睡眠教育。经过4周的积极治疗后，受试者停药并继续随访6个月。结果：与仅在教育对照组中总睡眠时间有显著改善相比，联合药物和放松组在总睡眠时间、睡眠效率和睡眠开始后觉醒时间的自我报告测量中观察到显著改善。在随访中，所有三个组在主要睡眠指标上均显示出显著改善。在生活质量指标方面也观察到积极变化，包括情绪状态和白天觉醒的自我评分。结论：这些发现为药物治疗与放松训练相结合在心理生理性失眠治疗中的价值提供了支持。
