National Institute of Mental Health, Klecany, Czech Republic.
Third Faculty of Medicine, Charles University, Prague, Czech Republic.
J Sleep Res. 2020 Aug;29(4):e13064. doi: 10.1111/jsr.13064. Epub 2020 May 20.
Although patients with insomnia often show a discrepancy between self-reported and objective sleep parameters, the role of and change in this phenomenon during treatment remain unclear. The present study aimed to assess the effect of cognitive behavioural therapy for insomnia on subjective and objective sleep discrepancy of total sleep time, sleep-onset latency and wake after sleep onset. The total sleep time discrepancy was also assessed across the entire therapy. The second aim was to examine the treatment outcome of two insomnia groups differing in sleep perception. Thirty-six adults with insomnia (mean age = 46.7 years, SD = 13.9; 22 females) were enrolled in the final analyses. Patients underwent a 6-week group cognitive behavioural therapy for insomnia programme. Sleep diary and actigraphy measurements were obtained during the therapy. Patients who underestimated total sleep time (n = 16; underestimating group) were compared with patients who accurately perceived or overestimated total sleep time (n = 20; accurate/overestimating group). After cognitive behavioural therapy for insomnia, a significant decrease of total sleep time and sleep-onset latency discrepancy was observed without a change in wake after sleep onset discrepancy in the total sample. Only the underestimating group reported decreased sleep-onset latency discrepancy after the treatment, whereas total sleep time discrepancy significantly changed in both groups. The underestimating group showed a significant decrease of total sleep time discrepancy from Week 1 to Week 2 when the sleep restriction was implemented, whereas the accurate/overestimating group showed the first significant change at Week 4. In conclusion, both groups differing in sleep perception responded similarly to cognitive behavioural therapy for insomnia, although different In conclusion, both groups differing in sleep perception responded similarly to cognitive behavioural therapy for insomnia, although different therapeutic components could play important roles in each group. components could play important roles in each group.
尽管失眠患者的自我报告睡眠参数与客观睡眠参数之间常常存在差异，但在治疗过程中这种现象的作用和变化仍不清楚。本研究旨在评估认知行为疗法治疗失眠对总睡眠时间、入睡潜伏期和睡眠后觉醒时间的主观和客观睡眠差异的影响。还评估了整个治疗过程中的总睡眠时间差异。第二个目的是研究睡眠感知不同的两组失眠患者的治疗效果。最终分析纳入了 36 名患有失眠症的成年人（平均年龄 46.7 岁，标准差 13.9；22 名女性）。患者接受了为期 6 周的团体认知行为疗法治疗失眠症。在治疗期间，获得了睡眠日记和活动记录仪测量结果。将低估总睡眠时间的患者（n=16；低估组）与准确感知或高估总睡眠时间的患者（n=20；准确/高估组）进行比较。认知行为疗法治疗失眠症后，总样本的总睡眠时间和入睡潜伏期差异显著减小，而睡眠后觉醒时间差异无变化。仅低估组报告入睡潜伏期差异减小，而两组的总睡眠时间差异均有显著变化。在实施睡眠限制时，低估组从第 1 周到第 2 周的总睡眠时间差异显著减小，而准确/高估组在第 4 周才出现首次显著变化。总之，睡眠感知不同的两组对认知行为疗法治疗失眠症的反应相似，尽管不同的治疗成分可能在每个组中发挥重要作用。
