Kang Seung-Gul, Kang Jae Myeong, Cho Seong-Jin, Ko Kwang-Pil, Lee Yu Jin, Lee Heon-Jeong, Kim Leen, Winkelman John W
Department of Psychiatry, Gil Medical Center, Gachon University, School of Medicine, Incheon, Republic of Korea.
Department of Preventive Medicine, Gachon University School of Medicine, Incheon, Republic of Korea.
J Clin Sleep Med. 2017 Apr 15;13(4):633-640. doi: 10.5664/jcsm.6564.
The use of telemedicine with a mobile application (MA) and a wearable device (WD) for the management of sleep disorders has recently received considerable attention. We designed an MA synchronizable with a WD for insomnia treatment. Our pilot study determined the efficacy of simplified group cognitive behavioral therapy for insomnia (CBT-I) delivered using our MA and assessed participant adherence to and satisfaction with the device.
The efficacy of the CBT-I using MA (CBT-I-MA) was assessed by comparing sleep variables (sleep efficiency [SE], Insomnia Severity Index [ISI], and Pittsburgh Sleep Quality Inventory [PSQI] scores) before and after a 4-week treatment protocol in 19 patients with insomnia disorder patients. SE was assessed using a sleep diary, actigraphy, and the PSQI.
The intervention significantly improved all three measures of SE ( < .05), and the response rate to treatment was high (94.7%). Total ISI and PSQI scores and sleep latency, as measured by the sleep diary, improved significantly. Participants showed relatively good adherence to our MA, and sleep diary entries were made on 24.3 ± 3.8 of 28 days. Moreover, 94.7% of the participants reported that our MA was effective for treating insomnia.
Our pilot study suggested the clinical usefulness of a CBT-I-MA. We expect that our findings will lead to further development and replication studies of CBT-I-MA.
利用移动应用程序(MA)和可穿戴设备(WD)进行远程医疗以管理睡眠障碍,最近受到了广泛关注。我们设计了一种可与WD同步的MA用于失眠治疗。我们的初步研究确定了使用我们的MA进行简化团体认知行为疗法治疗失眠(CBT-I)的疗效,并评估了参与者对该设备的依从性和满意度。
通过比较19名失眠症患者在为期4周的治疗方案前后的睡眠变量(睡眠效率[SE]、失眠严重程度指数[ISI]和匹兹堡睡眠质量指数[PSQI]得分),评估使用MA的CBT-I(CBT-I-MA)的疗效。使用睡眠日记、活动记录仪和PSQI评估SE。
干预显著改善了所有三项SE指标(P <.05),治疗反应率很高(94.7%)。睡眠日记测量的总ISI和PSQI得分以及睡眠潜伏期显著改善。参与者对我们的MA表现出相对较好的依从性,在28天中有24.3±3.8天记录了睡眠日记。此外,94.7%的参与者报告说我们的MA对治疗失眠有效。
我们的初步研究表明CBT-I-MA具有临床实用性。我们期望我们的研究结果将导致CBT-I-MA的进一步开发和重复研究。