Institute of Psychiatry, Kings College London, London, UK.
J Sleep Res. 2012 Jun;21(3):270-80. doi: 10.1111/j.1365-2869.2011.00940.x. Epub 2011 Aug 18.
Insomnia is a very common and disabling symptom. Whilst evidence for the efficacy of cognitive behavioural therapy for people diagnosed with insomnia (CBT-I) is strong, few people seek help and not many services offer CBT-I. Less intensive adaptations of CBT-I have been shown to be valuable, and given the size of the problem and low rates of help-seeking, an accessible intervention with a large capacity is needed. Day-long CBT-I psycho-educational workshops (each for up to 30 people), to which members of the public with insomnia symptoms could self-refer, have been developed. This randomised controlled trial aimed to evaluate the effectiveness of these workshops. Baseline measures were taken from 151 participants, who were then randomised to experimental or waiting-list control groups. Scores of the experimental group and the control group were compared 3 months after baseline. Random effects models found a significant interaction between time and group, indicating differences between the control and experimental groups on the Insomnia Severity Index (ISI). Post hoc analyses indicated that ISI scores decreased significantly in the experimental group, but not in the control group. Promising results were also found on corroborative sleep diary measures. Access to the workshops was good, with 50% of participants having never previously sought help for sleep difficulties from their GP. CBT-I workshops proved to be both accessible and effective in reducing insomnia symptoms in the medium term. They may represent a feasible brief intervention with the potential to address unmet treatment needs of adults complaining of insomnia symptoms.
失眠是一种非常常见且使人虚弱的症状。虽然针对被诊断患有失眠症(CBT-I)的人的认知行为疗法(CBT-I)的疗效证据确凿,但寻求帮助的人很少,提供 CBT-I 的服务也很少。已经证明,CBT-I 的不那么密集的改编版本也很有价值,考虑到问题的规模和寻求帮助的低比率,需要一种易于获得且具有大容量的干预措施。已经开发出了为期一天的 CBT-I 心理教育工作坊(每次最多可容纳 30 人),有失眠症状的公众可以自行参加。这项随机对照试验旨在评估这些工作坊的有效性。从 151 名参与者中获取了基线测量值,然后将他们随机分配到实验组或等待名单对照组。实验组和对照组的分数在基线后 3 个月进行了比较。随机效应模型发现时间和组之间存在显著的相互作用,这表明在失眠严重程度指数(ISI)上,对照组和实验组之间存在差异。事后分析表明,实验组的 ISI 评分显著下降,但对照组没有。在证实的睡眠日记测量方面也取得了可喜的结果。对工作坊的访问情况良好,有 50%的参与者之前从未因睡眠困难向他们的全科医生寻求过帮助。CBT-I 工作坊被证明在中期既易于获得,又能有效减轻失眠症状。它们可能代表一种可行的简短干预措施,有可能解决抱怨有失眠症状的成年人未得到满足的治疗需求。