Wu Y T, Wang J, Chen Y W, Guo W, Wu E L, Tang C R, Feng F, Feng Y S
Key Laboratory of Behavioral Science, Chinese Academy of Sciences, Institute of Psychology & Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China.
Department of Psychology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Zhonghua Nei Ke Za Zhi. 2018 Oct 1;57(10):731-737. doi: 10.3760/cma.j.issn.0578-1426.2018.10.007.
To evaluate the effectiveness of cognitive behavior therapy for insomnia (CBT-i) in chronic insomnia patients in terms of the improvements of psychological and sleep diary parameters. Patients who met the diagnostic criteria of chronic insomnia, were divided into primary group or comorbid group. Both groups received standard CBT-i interventions. Psychological scales and sleep diaries were used to evaluate participants' severity of insomnia and psychological conditions related to insomnia at four time points: before intervention (baseline), immediate after intervention, 4 weeks and 16 weeks after intervention. Both groups achieved significant improvements after intervention on psychological measurements and sleep diary parameters. Such improvements were maintained at 4-week and 16-week follow-ups. The sleep diary data indicated that by the end of the intervention, there were significant differences on sleep onset latency (51.72 min to 10.53 min in primary group, 0.01; 59.26 min to 15.67min in comorbid group, 0.01) and sleep efficiency (71% to 95% in primary group, 0.01; 68% to 90% in comorbid group, 0.01). There were differences on sleep onset latency (10.00 min vs. 13.93 min, 0.05), total sleep time (355.71 min vs. 327.85 min, 0.05) and sleep efficiency (95% vs. 91%, 0.01) in primary group and comorbid group respectively. No differences were found on wake after sleep onset in the two groups. Chronic insomnia patients with or without comorbidities both have improvements after CBT-i. Sleep diary parameters rather than psychological measurements are different in two groups. Thus, CBT-i is an effective non-pharmaceutical therapy inpatients with chronic insomnia.
从心理和睡眠日记参数改善方面评估认知行为疗法治疗失眠（CBT-i）对慢性失眠患者的有效性。符合慢性失眠诊断标准的患者被分为原发性组或共病组。两组均接受标准CBT-i干预。使用心理量表和睡眠日记在四个时间点评估参与者的失眠严重程度和与失眠相关的心理状况：干预前（基线）、干预后即刻、干预后4周和16周。两组在干预后心理测量和睡眠日记参数方面均取得显著改善。这些改善在4周和16周随访时得以维持。睡眠日记数据表明，到干预结束时，入睡潜伏期存在显著差异（原发性组从51.72分钟降至10.53分钟，P = 0.01；共病组从59.26分钟降至15.67分钟，P = 0.01）以及睡眠效率存在显著差异（原发性组从71%升至95%，P = 0.01；共病组从68%升至90%，P = 0.01）。原发性组和共病组在入睡潜伏期（10.00分钟对13.93分钟，P = 0.05）、总睡眠时间（355.71分钟对327.85分钟，P = 0.05）和睡眠效率（95%对91%，P = 0.01）方面分别存在差异。两组在睡眠中觉醒方面未发现差异。伴有或不伴有共病的慢性失眠患者在接受CBT-i治疗后均有改善。两组在睡眠日记参数而非心理测量方面存在差异。因此，CBT-i是治疗慢性失眠患者的一种有效的非药物疗法。
