Virginia Commonwealth University Richmond, VA.
J Clin Psychol. 2013 Oct;69(10):1108-20. doi: 10.1002/jclp.21938. Epub 2012 Dec 20.
To examine the effect of cognitive-behavioral therapy for insomnia (CBT-I) on the underreporting of sleep relative to objective measurement, a common occurrence among individuals with insomnia.
Pre-treatment and post-treatment self-report measures of sleep were compared with those obtained from home-based polysomnography (PSG) in 60 adults (mean age = 69.17; 42 women) with comorbid insomnia. The self-report data were published previously in a randomized controlled trial demonstrating the efficacy of CBT-I compared with a placebo treatment.
Self-report measures significantly underestimated sleep at pre-treatment and CBT-I led to a correction in this discrepancy. There were no significant changes in PSG after CBT-I. Path analysis showed that an increase in an objective proxy measure of sleep quality (i.e., decreased stage N1 sleep) after CBT-I was significantly related to improvements in self-report of sleep, with full mediation by reductions in discrepancy.
This is the first CBT-I outcome study to analyze discrepancy changes and demonstrate that these changes account for a significant portion of self-report outcome. In addition, improved sleep quality as measured by a decrease in percentage of stage N1 sleep following treatment may be one mechanism that explains why sleep estimation is more accurate following CBT-I.
研究认知行为疗法治疗失眠症（CBT-I）对相对于客观测量的睡眠低报的影响，这是失眠症患者中常见的现象。
对 60 名成年人（平均年龄=69.17；42 名女性）进行了治疗前和治疗后睡眠的自我报告测量，并与基于家庭的多导睡眠图（PSG）进行了比较。这些自我报告数据以前在一项随机对照试验中发表过，该试验表明 CBT-I 与安慰剂治疗相比具有疗效。
自我报告的测量在治疗前显著低估了睡眠，CBT-I 导致了这种差异的纠正。CBT-I 后 PSG 没有显著变化。路径分析显示，CBT-I 后客观睡眠质量代理指标（即 N1 期睡眠减少）的增加与睡眠自我报告的改善显著相关，差异的减少完全介导了这种关系。
这是第一项分析差异变化并证明这些变化占自我报告结果很大一部分的 CBT-I 结果研究。此外，治疗后 N1 期睡眠百分比减少表明睡眠质量提高，这可能是解释为什么 CBT-I 后睡眠估计更准确的一个机制。
