Department of Psychiatry, Stanford University School of Medicine, USA.
Department of Psychology, University of Houston,USA.
Behav Res Ther. 2018 Dec;111:106-112. doi: 10.1016/j.brat.2018.10.009. Epub 2018 Oct 27.
Sleep inertia involves decreased performance or disorientation upon waking that lasts several hours and impairs functioning. Though sleep inertia is common in insomnia and may interfere with treatment, Cognitive Behavioral Therapy for Insomnia (CBTI) does not routinely include a component to address sleep inertia. The present study evaluates such a component, the RISE-UP routine, in CBTI for insomnia comorbid with bipolar disorder. We hypothesized that the RISE-UP routine would increase physical activity in the morning and reduce the duration and severity of self-reported sleep inertia. Sleep and sleep inertia were monitored in the week prior to and following the intervention with daily sleep diaries, actigraphy, and ecological momentary assessment (EMA). Participants were randomized to a bipolar-specific modification of CBT-I (CBTI-BP) with RISE-UP (N = 20) or a psychoeducation (PE) comparison condition (N = 20). The treatment experiment (RISE-UP vs PE) was completed in the first treatment session. RISE-UP reduced the duration and severity of self-reported sleep inertia, as measured by diary reports and by EMA ratings, and was rated as acceptable and credible. Compliance was high, and increases in morning activity levels were verified via actigraphy. Addressing morning sleep inertia via behavioral modifications upon waking may be a useful addition to CBTI.
睡眠惯性是指醒来后持续数小时的表现下降或定向障碍，从而影响功能。尽管睡眠惯性在失眠中很常见，并且可能会干扰治疗，但认知行为疗法治疗失眠（CBTI）通常不包括解决睡眠惯性的部分。本研究评估了 CBTI 治疗双相情感障碍共病失眠中这种干预方法，即 RISE-UP 常规。我们假设 RISE-UP 常规会增加早晨的身体活动量，并减少自我报告的睡眠惯性的持续时间和严重程度。在干预前一周和干预后一周，通过每日睡眠日记、活动记录仪和生态瞬时评估（EMA）监测睡眠和睡眠惯性。参与者被随机分配到 CBTI-BP 与 RISE-UP（N=20）或心理教育（PE）对照条件（N=20）的双相特定修改版中。治疗实验（RISE-UP 与 PE）在第一次治疗会议中完成。RISE-UP 减少了自我报告的睡眠惯性的持续时间和严重程度，这通过日记报告和 EMA 评估来衡量，并且被评为可接受和可信的。依从性很高，并且通过活动记录仪验证了早晨活动水平的提高。通过醒来后的行为改变来解决早晨的睡眠惯性可能是 CBTI 的一个有用补充。
