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阻挡光线,睡个好觉:夜间蓝光过滤作为失眠认知行为疗法的一部分

Block the light and sleep well: Evening blue light filtration as a part of cognitive behavioral therapy for insomnia.

作者信息

Janků Karolina, Šmotek Michal, Fárková Eva, Kopřivová Jana

机构信息

Sleep Medicine and Chronobiology, National Institute of Mental Health, Klecany, Czech Republic.

Third Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.

出版信息

Chronobiol Int. 2020 Feb;37(2):248-259. doi: 10.1080/07420528.2019.1692859. Epub 2019 Nov 22.

Abstract

The objective of the present study was to assess the effect of combining CBT-I with wearing blue-light blocking glasses 90 min prior to bedtime on subjective and objective sleep parameters and daily symptoms (anxiety, depression, hyperarousal). Thirty patients (mean age 48.1 ± 16.13 years, range 21-71, 15 men/15 women) completed a CBT-I group therapy program, with groups randomly assigned to either "active" (blue-light filtering glasses) condition or "placebo" (glasses without filtering properties) condition. Patients were continually monitored by wristwatch actigraphy, kept their sleep diaries and completed a standard questionnaire battery at admission and after the end of the program. Statistical analyses showed a greater reduction of BAI score in "active" (4.33 ± 4.58) versus "placebo" (-0.92 ± 3.68) groups of patients [F = 6.389, = .019, Cohen's d = 1.26] and significant prolongation of subjective total sleep time in "active" (-36.88 ± 48.68 min.) versus "placebo" (7.04 ± 47.50 min.) [F = 8.56, p < .01, d = 0.91] group. When pre- and post-treatment results were compared in both groups separately, using paired-samples t-tests, significant differences were observed also in the active group for BDI-II score (t = 3.66, = .003, Cohen's d = 0.95) and HAS score (t = 2.90, = .012, Cohen's d = 0.75). No significant differences were found in the placebo group. In active group, there was also a significant reduction of subjective sleep latency (t = 2.65, = .021, d = 0.73) and an increase of subjective total sleep time (t = -2.73, = .018, d = -0.76) without change in objective sleep duration which was significantly shortened in the placebo group. We provide further evidence that blocking short-wavelength light in the evening hours may be beneficial for patients suffering from insomnia.

摘要

本研究的目的是评估将认知行为疗法失眠症治疗(CBT-I)与睡前90分钟佩戴蓝光阻挡眼镜相结合,对主观和客观睡眠参数以及日常症状(焦虑、抑郁、过度觉醒)的影响。30名患者(平均年龄48.1±16.13岁,范围21 - 71岁,15名男性/15名女性)完成了CBT-I团体治疗项目,各小组被随机分配到“主动”(蓝光过滤眼镜)组或“安慰剂”(无过滤功能的眼镜)组。通过腕部活动记录仪持续监测患者,患者记录睡眠日记,并在入院时和项目结束后完成一套标准问卷。统计分析显示,“主动”组(4.33±4.58)患者的贝克焦虑量表(BAI)得分较“安慰剂”组(-0.92±3.68)有更大幅度降低[F = 6.389,p = 0.019,科恩d值 = 1.26],且“主动”组(-36.88±48.68分钟)的主观总睡眠时间较“安慰剂”组(7.04±47.50分钟)显著延长[F = 8.56,p < 0.01,d = 0.91]。当分别使用配对样本t检验比较两组治疗前后的结果时,“主动”组在贝克抑郁量表第二版(BDI-II)得分(t = 3.66,p = 0.003,科恩d值 = 0.95)和高警觉量表(HAS)得分(t = 2.90,p = 0.012,科恩d值 = 0.75)方面也观察到显著差异。“安慰剂”组未发现显著差异。在“主动”组中,主观睡眠潜伏期也显著缩短(t = 2.65,p = 0.021,d = 0.73),主观总睡眠时间增加(t = -2.73,p = 0.018,d = -0.76),而客观睡眠时间无变化,“安慰剂”组的客观睡眠时间则显著缩短。我们提供了进一步的证据表明,在夜间阻挡短波长光可能对失眠患者有益。

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