青少年未解决的失眠症的简短行为治疗：一项单病例多基线试点研究，评估自我报告的疗效、安全性和可接受性结果。
A brief behavioral treatment for unresolved insomnia in adolescents: a single-case multiple baseline pilot study, evaluating self-reported outcomes of efficacy, safety, and acceptability.
作者信息
Quartly-Scott Gregory I, Miller Christopher B, Hawes David J
机构信息
Clinical Psychology Unit, School of Psychology, The University of Sydney, Sydney, Australia.
Nuffield Department of Clinical Neurosciences, Sleep and Circadian Neuroscience Institute, Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom.
出版信息
J Clin Sleep Med. 2020 Jan 15;16(1):97-105. doi: 10.5664/jcsm.8132. Epub 2019 Nov 26.
STUDY OBJECTIVES
Insomnia is a significant problem for many adolescents and often is associated with detrimental effects on physical and mental health. Drawing on emerging models of intervention in the adult literature, this pilot study investigated the efficacy, safety, and acceptability of a novel, brief (3-week) behavioral intervention among adolescents with unresolved chronic insomnia.
METHODS
A multiple baseline (staggered start) A-B with follow-up single-case design (n = 2) was used to evaluate intervention outcomes across treatment and at 2-month follow-up in the domains of sleep, mood and affect, fatigue, and parent-child conflict. Outcomes were indexed with multi-informant data collected using adolescent reports on mood/affect and sleep diaries, and parent reports on parent-child conflict.
RESULTS
Posttreatment and 2-month follow-up data indicated improvements in self-reported sleep quality, including sleep onset latency and increased sleep efficiency. Indicators related to participant mood, stress, and parent-child interactions remained relatively stable over the course of treatment, suggesting that the sleep restriction component of the intervention did not produce adverse effects for the adolescents or their families.
CONCLUSIONS
A brief 3-week intervention adapted from the adult literature was associated with improved sleep-wake cycles in adolescents with chronic insomnia. Change during the treatment phase was particularly rapid and maintained over time. In conjunction with low observed risk and adverse effects, the potential for this treatment to provide a safe, acceptable, and cost-effective manualized treatment for adolescent insomnia warrants larger-scale clinical evaluation.
CLINICAL TRIAL REGISTRATION
Registry: Australian New Zealand Clinical Trials Registry; Title: Does a one month brief behavioral treatment improve sleep for high school adolescents (ages 12-17): an open label pilot study; Identifier: ACTRN12618000835246; URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375102.
研究目的
失眠对许多青少年来说是一个严重问题，且常常与身心健康的不良影响相关。借鉴成人文献中新兴的干预模式，这项试点研究调查了一种新颖的、为期3周的简短行为干预对患有慢性失眠且未得到解决的青少年的疗效、安全性和可接受性。
方法
采用多基线（交错开始）A-B及随访单病例设计（n = 2）来评估治疗期间及2个月随访时在睡眠、情绪与情感、疲劳以及亲子冲突等方面的干预结果。结果通过多渠道数据进行索引，这些数据是使用青少年关于情绪/情感和睡眠日记的报告以及父母关于亲子冲突的报告收集而来的。
结果
治疗后及2个月随访数据表明，自我报告的睡眠质量有所改善，包括入睡潜伏期缩短和睡眠效率提高。在治疗过程中，与参与者情绪、压力及亲子互动相关的指标保持相对稳定，这表明干预中的睡眠限制部分并未对青少年及其家庭产生不利影响。
结论
源自成人文献的为期3周的简短干预与患有慢性失眠的青少年的睡眠-觉醒周期改善相关。治疗阶段的变化尤为迅速且随时间得以维持。鉴于观察到的低风险和不良反应，这种治疗方法有可能为青少年失眠提供一种安全、可接受且具有成本效益的手册化治疗方案，值得进行大规模临床评估。
临床试验注册
注册机构：澳大利亚新西兰临床试验注册中心；标题：为期一个月的简短行为治疗能否改善高中青少年（12 - 17岁）的睡眠：一项开放标签试点研究；标识符：ACTRN12618000835246；网址：https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375102 。
Zotero 插件