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[一种用于失眠症的在线认知行为疗法的有效性]

[Effectiveness of an online cognitive behavioral therapy for insomnia].

作者信息

Friðgeirsdóttir Guðlaug, Jóhannsson Gunnar, Ellertsson Steindór, Björnsdóttir Erla

出版信息

Laeknabladid. 2015 Apr;101(4):203-8. doi: 10.17992/lbl.2015.04.20.

Abstract

INTRODUCTION

Insomnia is a common health problem with serious mental and physical consequences as well as increased economical costs. The use of hypnotics in Iceland is immense in spite of cognitive behavioral therapy for insomnia (CBT-I) being recommended as the first choice treatment of chronic insomnia. To meet the needs of more individuals suffering from insomnia, online CBT-I was established at betrisvefn.is. The objective of this research was to evaluate the effectiveness of this internet-based CBT-I.

MATERIAL AND METHODS

One hundred seventy-five users (mean age 46 y (18-79 y)) started a 6 week online intervention for insomnia. The drop-out rate was 29%, leaving a final sample of 125 users. The intervention is based on well-established face-to-face CBT-I. Sleep diaries were used to determine changes in sleep efficiency, sleep onset latency and wake after sleep onset. Treatment effects were assesed after 6 weeks of treatment and at the 6 week follow-up.

RESULTS

Significant improvement was found in all main sleep variables except for 5% decrease in total sleep time (TST). Effects were sustained at 6 week follow-up and TST increased. The use of hypnotics decreased significantly. This form of treatment seems to suit its users very well and over 94% would recommend the treatment.

CONCLUSION

Internet interventions for insomnia seem to have good potential. CBT-I will hopefully be offered as the first line treatment for chronic insomnia in Iceland instead of hypnotics as the availability of the CBT-I is growing. Thus, the burden on health care clinics might reduce along with the hypnotics use and the considerable costs of insomnia.

摘要

引言

失眠是一个常见的健康问题,会导致严重的身心后果以及经济成本增加。尽管认知行为疗法(CBT-I)被推荐为慢性失眠的首选治疗方法,但冰岛对催眠药物的使用量仍然很大。为了满足更多失眠患者的需求,betrisvefn.is网站推出了在线CBT-I。本研究的目的是评估这种基于互联网的CBT-I的有效性。

材料与方法

175名用户(平均年龄46岁(18 - 79岁))开始了为期6周的失眠在线干预。脱落率为29%,最终样本为125名用户。该干预基于成熟的面对面CBT-I。使用睡眠日记来确定睡眠效率、入睡潜伏期和睡眠后觉醒时间的变化。在治疗6周后和6周随访时评估治疗效果。

结果

除总睡眠时间(TST)减少5%外,所有主要睡眠变量均有显著改善。在6周随访时效果持续存在,且TST增加。催眠药物的使用显著减少。这种治疗形式似乎很适合其用户,超过94%的用户会推荐该治疗方法。

结论

失眠的互联网干预似乎具有很大潜力。随着CBT-I可用性的增加,冰岛有望将CBT-I作为慢性失眠的一线治疗方法,而不是催眠药物。因此,医疗保健诊所的负担可能会随着催眠药物使用的减少以及失眠带来的可观成本而降低。

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