Rybarczyk Bruce, Lopez Martita, Benson Rodney, Alsten Christopher, Stepanski Edward
Department of Psychology, Rush-Presbyterian-St Luke's Medical Center, Rush University, Chicago, Illinois 60612-3833, USA.
Psychol Aging. 2002 Jun;17(2):288-98.
Older adults with comorbid insomnia and medical illness have been excluded from behavioral treatment research, but recent evidence suggested that such treatments would be effective with this population. In this study, 38 older adults with comorbid insomnia were randomized to 1 of 3 conditions: classroom cognitive-behavioral treatment (CBT), home-based audio relaxation treatment (HART), or delayed-treatment control. Compared to the control group, the CBT group had significant changes in 5 of 7 self-report measures of sleep at the 4-month follow-up. The HART group obtained significant outcomes on 3 of 7 measures. Wrist actigraphy measures and secondary-outcome measures did not yield significant findings for either treatment. Clinically significant changes at follow-up were obtained for 54% of patients in CBT, 35% in HART, and 6% in the control group when treatment dropouts were included. Although not as effective as in-person CBT, home interventions may have utility as a first-line, low-cost treatment.
患有共病性失眠和内科疾病的老年人被排除在行为治疗研究之外,但最近的证据表明,这类治疗方法对该人群有效。在本研究中,38名患有共病性失眠的老年人被随机分配到3种情况中的1种:课堂认知行为疗法(CBT)、家庭音频放松疗法(HART)或延迟治疗对照组。与对照组相比,CBT组在4个月随访时7项睡眠自我报告测量指标中的5项有显著变化。HART组在7项测量指标中的3项取得了显著结果。两种治疗方法的腕部活动记录仪测量和次要结果测量均未得出显著结果。当纳入治疗退出者时,CBT组54%的患者、HART组35%的患者和对照组6%的患者在随访时出现了具有临床意义的变化。虽然不如面对面CBT有效,但家庭干预可能作为一线低成本治疗方法具有实用价值。