Flinders University, School of Psychology, Adelaide, S.A., Australia.
Flinders University, School of Psychology, Adelaide, S.A., Australia.
Sleep Med. 2018 May;45:44-48. doi: 10.1016/j.sleep.2017.10.007. Epub 2017 Nov 2.
Sleep restriction therapy (SRT) is a largely untested single treatment component of cognitive-behaviour therapy for insomnia. To date, the evidence for contraindications for SRT is limited to very few studies. The present study investigated the objective and subjective daytime consequences during the acute phase of SRT for adults diagnosed with Chronic Insomnia Disorder.
Sixteen adults (age = 36.3 ± 13.4 yrs, 12 females, 4 males) underwent SRT for their insomnia over a two week period based on recommendations by Miller and colleagues (2014) [6]. Participants completed sleep diaries, self-reported daytime sleepiness (Epworth Sleepiness Scale [ESS]), as well as objective measures of reaction time/inhibition (Go/NoGo task) and driving performance (AusEd driving simulator) at pre-, mid- (ie, after one week of SRT) and post-SRT (after two weeks of SRT).
Sleep diary outcomes indicated participants complied with the restriction of time in bed, and that a similar amount of total sleep time (TST) was maintained from pre-to-post-treatment. There was no significant change in daytime sleepiness, and similarly no significant changes observed in objective performance on the Go/NoGo task and AusEd driving simulator.
These preliminary results suggest SRT during the acute phase does not appear to place insomnia patients at risk of significant impairments in sleepiness and reaction times. We note these findings can only be translated into clinical practice when sleep duration remains relatively unchanged. Future studies using objective measures of sleep and a control group are recommended.
睡眠限制疗法（SRT）是认知行为疗法治疗失眠症的一种未经大量测试的单一治疗方法。迄今为止，SRT 的禁忌症证据仅限于极少数研究。本研究调查了被诊断为慢性失眠症的成年人在 SRT 的急性阶段期间的客观和主观日间后果。
16 名成年人（年龄=36.3±13.4 岁，12 名女性，4 名男性）根据 Miller 及其同事（2014 年）的建议[6]接受了为期两周的 SRT 治疗。参与者在治疗前、中期（即 SRT 一周后）和治疗后（SRT 两周后）完成睡眠日记、自我报告的日间嗜睡（Epworth 嗜睡量表[ESS]）以及反应时间/抑制（Go/NoGo 任务）和驾驶性能（AusEd 驾驶模拟器）的客观测量。
睡眠日记结果表明，参与者遵守了睡眠时间限制，并且从治疗前到治疗后，总睡眠时间（TST）保持不变。日间嗜睡没有显著变化，Go/NoGo 任务和 AusEd 驾驶模拟器的客观表现也没有显著变化。
这些初步结果表明，在急性阶段进行 SRT 似乎不会使失眠症患者面临严重的嗜睡和反应时间受损的风险。我们注意到，只有当睡眠时间相对不变时，这些发现才能转化为临床实践。建议使用客观的睡眠测量和对照组进行未来的研究。
