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基于互联网的失眠认知行为疗法(ICBT-i):随机对照试验的荟萃分析

Internet-based cognitive-behavioural therapy for insomnia (ICBT-i): a meta-analysis of randomised controlled trials.

作者信息

Ye Yuan-Yuan, Chen Ni-Ka, Chen Jia, Liu Juan, Lin Ling, Liu Ya-Zhen, Lang Ying, Li Xun-Jun, Yang Xin-Ju, Jiang Xiao-Jiang

机构信息

Department of Neurology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.

Department of Neurology, PLA 187 Hospital, Haikou, China.

出版信息

BMJ Open. 2016 Nov 30;6(11):e010707. doi: 10.1136/bmjopen-2015-010707.

Abstract

OBJECTIVE

To evaluate the effectiveness of internet-based cognitive-behavioural therapy for insomnia (ICBT-i) in adults.

DESIGN

A meta-analysis of ICBT-i.

DATA SOURCES

Systematic searches of randomised controlled trials of ICBT-i were performed in the PubMed, EMBASE, PsycINFO and Cochrane Library databases up to 19 June 2016.

REVIEW METHOD

2 reviewers independently performed study selection, quality assessment and data extraction. Outcomes of interest included sleep onset latency (SOL), total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of nocturnal awakenings (NWAK), and Insomnia Severity Index (ISI). RevMan 5.2 and Stata 13.0 meta-analysis software were used to perform statistical analysis.

RESULTS

14 records for 15 studies (1013 experimental group participants, 591 waiting list group participants) were included. The meta-analysis indicated that, at the post-test time point, SOL decreased by 18.41 min (95% CI 13.60 to 23.21), TST increased by 22.30 min (95% CI 16.38 to 28.23), SE increased by 9.58% (95% CI 7.30% to 11.85%), WASO decreased by 22.31 min (95% CI 13.50 to 31.11), NWAK decreased by 0.52 (95% CI 0.28 to 0.76), and ISI decreased by 5.88 points (95% CI 4.29 to 7.46). Additionally SOL, TST, SE, and WASO exhibited statistically significant improvements at follow-up versus before treatment.

CONCLUSIONS

ICBT-i is an effective treatment for adults with insomnia. This conclusion should be verified in further studies.

摘要

目的

评估基于互联网的成人失眠认知行为疗法(ICBT-i)的有效性。

设计

ICBT-i的荟萃分析。

数据来源

截至2016年6月19日,在PubMed、EMBASE、PsycINFO和Cochrane图书馆数据库中对ICBT-i的随机对照试验进行系统检索。

综述方法

2名评审员独立进行研究选择、质量评估和数据提取。感兴趣的结果包括入睡潜伏期(SOL)、总睡眠时间(TST)、睡眠效率(SE)、睡眠中觉醒时间(WASO)、夜间觉醒次数(NWAK)和失眠严重程度指数(ISI)。使用RevMan 5.2和Stata 13.0荟萃分析软件进行统计分析。

结果

纳入了15项研究的14条记录(1013名实验组参与者,591名等待列表组参与者)。荟萃分析表明,在测试后时间点,SOL减少了18.41分钟(95%CI 13.60至23.21),TST增加了22.30分钟(95%CI 16.38至28.23),SE增加了9.58%(95%CI 7.30%至11.85%),WASO减少了22.31分钟(95%CI 13.50至31.11),NWAK减少了0.52(95%CI 0.28至0.76),ISI减少了5.88分(95%CI 4.29至7.46)。此外,随访时与治疗前相比,SOL、TST、SE和WASO有统计学显著改善。

结论

ICBT-i是治疗成人失眠的有效方法。这一结论应在进一步研究中得到验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d182/5168528/868a689aa97f/bmjopen2015010707f01.jpg

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