Phoenix Veterans Affairs Health Care System, Phoenix, AZ, USA.
Sleep. 2012 Jun 1;35(6):797-805. doi: 10.5665/sleep.1878.
Recently, the use of multicomponent insomnia treatment has increased. This study compares the effect of single component and multicomponent behavioral treatments for insomnia in older adults after intervention and at 3 months and 1 yr posttreatment.
A randomized, controlled study.
Veterans Affairs medical center.
179 older adults (mean age, 68.9 yr ± 8.0; 115 women [64.2%]) with chronic primary insomnia.
Participants were randomly assigned to 6 wk of stimulus control therapy (SCT), sleep restriction therapy (SRT), the 2 therapies combined into a multicomponent intervention (MCI), or a wait-list control group.
Primary outcomes were subjective (daily sleep diary) and objective (actigraphy) measures of sleep-onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TIB), and sleep efficiency (SE). Secondary outcomes were clinical measures including response and remission rates. There were no differences between the single and multicomponent interventions on primary sleep outcomes measured by diary and actigraphy. All treatments produced significant improvement in diary-reported sleep in comparison with the control group. Effect sizes for sleep diary outcomes were medium to large. Treatment gains were maintained at follow-up for diary and actigraph measured SOL, WASO, and SE. The MCI group had the largest proportion of treatment remitters.
For older adults with chronic primary insomnia, the findings provide initial evidence that SCT, SRT, and MCI are equally efficacious and produce sustainable treatment gains on diary, actigraphy, and clinical outcomes. From a clinical perspective, MCI may be a preferred treatment due to its higher remission rate.
Behavioral Intervention for Insomnia in Older Adults. NCT01154023. URL: http://clinicaltrials.gov/ct2/show/NCT01154023?term=Behavioral+Intervention+for+Insomnia+in+Older+Adults&rank=1.
最近，多成分失眠治疗的应用有所增加。本研究比较了单一成分和多成分行为治疗对老年人失眠的干预效果以及治疗后 3 个月和 1 年的效果。
一项随机对照研究。
退伍军人事务医疗中心。
179 名年龄在 68.9 岁±8.0 岁（115 名女性[64.2%]）的慢性原发性失眠症老年人。
参与者被随机分配到 6 周的刺激控制疗法（SCT）、睡眠限制疗法（SRT）、两种疗法结合的多成分干预（MCI）或候补名单对照组。
主要结果是主观（每日睡眠日记）和客观（活动记录仪）测量的入睡潜伏期（SOL）、睡眠后觉醒（WASO）、总睡眠时间（TST）、在床上时间（TIB）和睡眠效率（SE）。次要结果是包括反应率和缓解率在内的临床指标。在日记和活动记录仪测量的睡眠结果方面，单一和多成分干预之间没有差异。与对照组相比，所有治疗方法都显著改善了日记报告的睡眠。日记测量结果的治疗效果为中到大。治疗效果在随访时保持稳定，包括日记和活动记录仪测量的 SOL、WASO 和 SE。MCI 组有最大比例的治疗缓解者。
对于患有慢性原发性失眠症的老年人，研究结果初步表明，SCT、SRT 和 MCI 同样有效，并在日记、活动记录仪和临床结果上产生可持续的治疗效果。从临床角度来看，由于 MCI 的缓解率较高，它可能是一种更受欢迎的治疗方法。
老年人失眠的行为干预。NCT01154023。网址：http://clinicaltrials.gov/ct2/show/NCT01154023?term=Behavioral+Intervention+for+Insomnia+in+Older+Adults&rank=1。
