Nationwide Children's Hospital, The Ohio State University Department of Pediatrics, 700 Children's Drive, JWest 4th Floor, Columbus, OH 43205, USA.
Sleep Med Rev. 2015 Oct;23:20-7. doi: 10.1016/j.smrv.2014.11.002. Epub 2014 Nov 18.
Cognitive-behavioral treatment for insomnia and continuous positive airway pressure therapy for obstructive sleep apnea are among the most efficacious sleep interventions. Unfortunately, adherence levels are disappointingly low for these interventions. Behavioral economics offers a promising framework for promoting adherence, often through relatively brief and straightforward strategies. The assumptions, goals, and key strategies of behavioral economics will be introduced. These strategies include providing social norms information, changing defaults, using the compromise effect, utilizing commitment devices, and establishing lottery-based systems. Then, this review will highlight specific behavioral economic approaches to promote patient adherence for three major sleep interventions: 1) behavioral treatment for pediatric insomnia, 2) cognitive-behavioral treatment for adult insomnia, and 3) continuous positive airway pressure for obstructive sleep apnea. Next, behavioral economic strategies will be discussed as ways to improve health care provider adherence to clinical practice guidelines regarding appropriate prescribing of hypnotics and ordering sleep-promoting practices for hospitalized inpatients. Finally, possible concerns that readers may have about behavioral economics strategies, including their efficacy, feasibility, and sustainability, will be addressed.
认知行为疗法治疗失眠和持续气道正压通气疗法治疗阻塞性睡眠呼吸暂停是最有效的睡眠干预措施之一。不幸的是，这些干预措施的依从率低得令人失望。行为经济学为促进依从性提供了一个有前途的框架，通常通过相对简单和直接的策略。本文将介绍行为经济学的假设、目标和关键策略。这些策略包括提供社会规范信息、改变默认设置、利用妥协效应、使用承诺设备和建立基于彩票的系统。然后，本文将重点介绍促进三种主要睡眠干预措施患者依从性的具体行为经济学方法：1）儿童失眠的行为治疗；2）成人失眠的认知行为治疗；3）阻塞性睡眠呼吸暂停的持续气道正压通气。接下来，将讨论行为经济学策略作为提高医疗保健提供者依从性的一种方式，以适当开具催眠药物和为住院患者提供促进睡眠的实践的临床实践指南。最后，将讨论读者可能对行为经济学策略存在的一些担忧，包括其疗效、可行性和可持续性。
