Koffel Erin, Farrell-Carnahan Leah
Minneapolis Veterans Affairs Medical Center, One Veterans Drive, Minneapolis, MN 55417.
Hunter Holmes McGuire Veterans Affairs Medical Center, 1201 Broad Rock Boulevard, Richmond, VA 23224.
Mil Med. 2014 May;179(5):521-8. doi: 10.7205/MILMED-D-13-00455.
Insomnia is increasingly common among the general population, even more so among veterans. Given the adverse impact of insomnia on both mental and physical health of veterans, it is important to provide effective treatments within the Veterans Health Administration (VHA) system. Group-based cognitive behavioral therapy for insomnia (CBT-I) provides a viable option for treatment. This study reports the feasibility, acceptability, initial effectiveness, and durability of group-based CBT-I in a clinical sample of veterans with comorbid medical and mental health diagnoses; the treatment was provided in a real-world VHA hospital setting using a manualized protocol that was explicitly adapted from the existing 1:1 CBT-I VHA protocol. Overall, we found the treatment to be feasible and acceptable to veterans, as well as effective. We found medium to large effect sizes for both questionnaire and sleep diary measures, including sleep onset latency, awakenings during the night, sleep efficiency, insomnia scores, and dysfunctional beliefs about sleep. Improvements in insomnia symptoms were maintained over 1 month.
失眠在普通人群中越来越普遍，在退伍军人中更是如此。鉴于失眠对退伍军人的身心健康都有不利影响，在退伍军人健康管理局（VHA）系统内提供有效的治疗方法很重要。基于团体的失眠认知行为疗法（CBT-I）为治疗提供了一个可行的选择。本研究报告了基于团体的CBT-I在患有合并医疗和心理健康诊断的退伍军人临床样本中的可行性、可接受性、初始有效性和持久性；该治疗是在一家真实的VHA医院环境中，使用从现有的一对一VHA CBT-I方案明确改编而来的手册化方案进行的。总体而言，我们发现该治疗对退伍军人来说是可行且可接受的，也是有效的。我们在问卷和睡眠日记测量中发现了中等到较大的效应量，包括入睡潜伏期、夜间觉醒、睡眠效率、失眠评分以及对睡眠的功能失调信念。失眠症状的改善在1个月内得以维持。
