Jansson-Fröjmark Markus, Linton Steven J, Flink Ida K, Granberg Sarah, Danermark Berth, Norell-Clarke Annika
School of Law, Psychology, and Social Work, Örebro University, SE-701 82, Örebro, Sweden.
J Clin Psychol Med Settings. 2012 Jun;19(2):224-34. doi: 10.1007/s10880-011-9275-y.
The purpose of the current study was to examine the effects of cognitive behavior therapy (CBT-I) for insomnia on patients with insomnia co-morbid with hearing impairment. A randomized controlled design was used with a 3-month follow-up. Thirty-two patients with insomnia co-morbid with hearing impairment were randomized to either CBT-I or a waitlist condition (WLC). The primary outcome was insomnia severity. Secondary outcomes were sleep diary parameters, dysfunction, anxiety, and depression. Compared to WLC, CBT-I resulted in lower insomnia severity at post-treatment and at follow-up (d = 1.18-1.56). Relative to WLC, CBT-I also led, at both assessment points, to reduced total wake time (d = 1.39) and increased sleep restoration (d = 1.03-1.07) and sleep quality (d = 0.91-1.16). Both groups increased their total sleep time, but no significant group difference emerged. Compared to WLC, CBT-I resulted in higher function (d = 0.81-0.96) and lower anxiety (d = 1.29-1.30) at both assessment points. Neither CBT-I nor WLC led to improvement on depression. Based on the Insomnia Severity Index, more CBT-I (53-77%) than WLC participants (0-7%) were treatment responders. Also, more CBT-I (24%) than WLC participants (0%) remitted. In patients with insomnia co-morbid with hearing impairment, CBT-I was effective in decreasing insomnia severity, subjective sleep parameters, dysfunction, and anxiety. These findings are in line with previous results on the effects of CBT-I in other medical conditions.
本研究旨在探讨认知行为疗法（CBT-I）治疗失眠对合并听力障碍的失眠患者的影响。采用随机对照设计，并进行3个月的随访。32例合并听力障碍的失眠患者被随机分为CBT-I组或等待名单对照组（WLC）。主要结局指标为失眠严重程度。次要结局指标包括睡眠日记参数、功能障碍、焦虑和抑郁。与WLC相比，CBT-I在治疗后及随访时导致更低的失眠严重程度（d=1.18-1.56）。相对于WLC，CBT-I在两个评估点还导致总觉醒时间减少（d=1.39）、睡眠恢复增加（d=1.03-1.07）以及睡眠质量提高（d=0.91-1.16）。两组的总睡眠时间均增加，但未出现显著的组间差异。与WLC相比，CBT-I在两个评估点均导致更高的功能水平（d=0.81-0.96）和更低的焦虑水平（d=1.29-1.30）。CBT-I组和WLC组均未使抑郁症状得到改善。根据失眠严重程度指数，CBT-I组的治疗有效者（53-77%）多于WLC组（0-7%）。此外，CBT-I组的缓解者（24%）多于WLC组（0%）。对于合并听力障碍的失眠患者，CBT-I在降低失眠严重程度、主观睡眠参数、功能障碍和焦虑方面有效。这些发现与之前关于CBT-I在其他医疗状况下疗效的结果一致。
