Birling Yoann, Wang Jian, Li Guixia, Wu Enlai, Yu Zhidan, Feng Yunshu, Wu Yuting
Guang'an Men Hospital, Beijing, 100053, China.
Institute of Psychology, Chinese Academy of Sciences, Beijing, 100049, China.
Int J Behav Med. 2018 Jun;25(3):331-340. doi: 10.1007/s12529-017-9710-z.
Insomnia is a common mental disorder with severe consequences. Cognitive-behavioral therapy for insomnia (CBTI) has been proved effective against insomnia, but most of the research is limited to Western countries. This trial objective is to develop a Chinese culture-adapted CBTI program and assess its efficacy.
An 8-week culturally adapted CBTI program was developed that included mixed group and individual session and culturally adapted relaxation and cognitive restructuring treatment components. A one-arm clinical trial was conducted at a public hospital between March 2016 and January 2017. Seventy-two Chinese adults (15 males, 57 females; mean age, 50 years) with insomnia disorder underwent the culturally adapted CBTI program. Sleep diaries and self-report scales, as well as polysomnography (PSG, for a subgroup only), were used to assess qualitative and quantitative measures of sleep, mental health status, and quality of life at baseline, post-treatment, and 4-month follow-up.
Pre-post analyses showed significant changes in sleep diary sleep onset latency (SOL), wake after sleep onset (WASO), and total sleep time of respectively - 37.03 min (CI, - 48.90 to - 25.16), - 28.16 min (CI, - 40.22 to - 16.10), and + 27.49 min (CI, 10.51 to 44.47). Self-reported sleep quality, mental health, and quality of life improved compared to baseline. The self-reported outcomes were mainly stable at follow-up. PSG outcomes globally failed to show improvement.
The design of a CBTI program adapted to Chinese population was achieved. Culturally adapted CBTI showed promising results. More rigorously designed studies are needed to ensure efficacy.
失眠是一种常见的精神障碍，后果严重。失眠的认知行为疗法（CBTI）已被证明对失眠有效，但大多数研究仅限于西方国家。本试验的目的是开发一种适应中国文化的CBTI方案并评估其疗效。
开发了一个为期8周的适应文化的CBTI方案，包括混合小组和个体治疗环节，以及适应文化的放松和认知重构治疗成分。2016年3月至2017年1月在一家公立医院进行了单臂临床试验。72名患有失眠症的中国成年人（15名男性，57名女性；平均年龄50岁）接受了适应文化的CBTI方案。使用睡眠日记和自我报告量表，以及多导睡眠图（仅对一个亚组进行）来评估基线、治疗后和4个月随访时睡眠、心理健康状况和生活质量的定性和定量指标。
前后分析显示，睡眠日记中的入睡潜伏期（SOL）、睡眠中觉醒时间（WASO）和总睡眠时间分别有显著变化，分别为-37.03分钟（可信区间，-48.90至-25.16）、-28.16分钟（可信区间，-40.22至-16.10）和+27.49分钟（可信区间，10.51至44.47）。与基线相比，自我报告的睡眠质量、心理健康和生活质量有所改善。自我报告的结果在随访时基本稳定。多导睡眠图的结果总体上没有显示出改善。
实现了适应中国人群的CBTI方案的设计。适应文化的CBTI显示出有希望的结果。需要更严格设计的研究来确保疗效。
