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一项关于加重链毯治疗精神疾病失眠症的随机对照研究。

A randomized controlled study of weighted chain blankets for insomnia in psychiatric disorders.

作者信息

Ekholm Bodil, Spulber Stefan, Adler Mats

机构信息

The Affective Disorder Outpatient Clinic at Psychiatry Southwest, Karolinska University Hospital Huddinge, Stockholm, Sweden.

Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.

出版信息

J Clin Sleep Med. 2020 Sep 15;16(9):1567-1577. doi: 10.5664/jcsm.8636.

Abstract

STUDY OBJECTIVES

This study aimed to evaluate the effect of weighted chain blankets on insomnia and sleep-related daytime symptoms for patients with major depressive disorder, bipolar disorder, generalized anxiety disorder, and attention deficit hyperactivity disorder.

METHODS

One hundred twenty patients were randomized (1:1) to either a weighted metal chain blanket or a light plastic chain blanket for 4 weeks. The outcome was evaluated using the Insomnia Severity Index as primary outcome measure and day and night diaries, Fatigue Symptom Inventory, and Hospital Anxiety and Depression Scale as secondary outcome measures. Sleep and daytime activity levels were evaluated by wrist actigraphy.

RESULTS

At 4 weeks, there was a significant advantage in Insomnia Severity Index ratings of the weighted blanket intervention over the light blanket (P < .001) with a large effect size (Cohen's d 1.90). The intervention by the weighted blanket resulted in a significantly better sleep-maintenance, a higher daytime activity level, and reduced daytime symptoms of fatigue, depression, and anxiety. No serious adverse events occurred. During a 12-month open follow-up phase of the study, participants continuing to use weighted blankets maintained the effect on sleep, while patients switching from a light to a weighted blanket experienced an effect on Insomnia Severity Index ratings similar to that of participants using the weighted blanket from the beginning.

CONCLUSIONS

Weighted chain blankets are an effective and safe intervention for insomnia in patients with major depressive disorder, bipolar disorder, generalized anxiety disorder, or attention deficit hyperactivity disorder, also improving daytime symptoms and levels of activity.

CLINICAL TRIAL REGISTRATION

Registry: ClinicalTrials.gov; Name: Controlled Study of Chain Blanket for Insomnia; URL: https://clinicaltrials.gov/ct2/show/NCT03546036; Identifier: NCT03546036.

摘要

研究目的

本研究旨在评估加重链毯对重度抑郁症、双相情感障碍、广泛性焦虑症和注意力缺陷多动障碍患者失眠及与睡眠相关的日间症状的影响。

方法

120名患者被随机(1:1)分为使用加重金属链毯组或轻质塑料链毯组,为期4周。使用失眠严重程度指数作为主要结局指标进行评估,并使用日夜日记、疲劳症状量表和医院焦虑抑郁量表作为次要结局指标。通过手腕活动记录仪评估睡眠和日间活动水平。

结果

4周时,加重毯干预组的失眠严重程度指数评分显著优于轻质毯组(P <.001),效应量较大(科恩d值为1.90)。加重毯干预使睡眠维持情况显著改善、日间活动水平提高,并减轻了日间疲劳、抑郁和焦虑症状。未发生严重不良事件。在该研究为期12个月的开放随访阶段,继续使用加重毯的参与者维持了对睡眠的影响,而从轻质毯转换为加重毯的患者在失眠严重程度指数评分上的变化与从一开始就使用加重毯的参与者相似。

结论

加重链毯是治疗重度抑郁症、双相情感障碍、广泛性焦虑症或注意力缺陷多动障碍患者失眠的一种有效且安全的干预措施,还可改善日间症状和活动水平。

临床试验注册

注册机构:ClinicalTrials.gov;名称:链毯治疗失眠的对照研究;网址:https://clinicaltrials.gov/ct2/show/NCT03546036;标识符:NCT03546036。

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