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认知行为疗法治疗失眠对心血管疾病早期标志物似乎没有显著影响:一项初步的随机对照试验。

Cognitive behavioural therapy for insomnia does not appear to have a substantial impact on early markers of cardiovascular disease: A preliminary randomized controlled trial.

机构信息

Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany.

Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

出版信息

J Sleep Res. 2020 Oct;29(5):e13102. doi: 10.1111/jsr.13102. Epub 2020 Jun 28.

Abstract

According to the World Health Organization, cardiovascular diseases are the leading cause of death in the world. Therefore, early prevention of these diseases is a public health priority. Epidemiological data suggest that insomnia may be a modifiable risk factor for cardiovascular diseases. A randomized controlled trial in a sample of insomnia patients without cardiovascular disease was conducted to investigate the effects of insomnia treatment on early markers of cardiovascular diseases assessed by 24-hr ambulatory blood pressure, heart rate and heart rate variability monitoring, and morning fasting blood samples. Forty-six patients with insomnia disorder were randomized to cognitive behavioural therapy for insomnia (CBT-I; n = 23) or a waitlist control condition (n = 23). Contrary to the hypothesis, intention-to-treat analyses did not show any significant treatment effects on early markers of cardiovascular disease (d = 0.0-0.6) despite successful insomnia treatment (d = 1.3). Potential methodological and conceptual reasons for these negative findings are discussed. Future studies might include larger sample sizes that are at risk of cardiovascular diseases and focus on other cardiovascular markers.

摘要

根据世界卫生组织的数据,心血管疾病是全球范围内的主要死因。因此,早期预防这些疾病是公共卫生的重点。流行病学数据表明,失眠可能是心血管疾病的一个可改变的危险因素。一项针对无心血管疾病的失眠患者样本的随机对照试验,旨在通过 24 小时动态血压、心率和心率变异性监测以及早晨空腹血样,调查失眠治疗对心血管疾病早期标志物的影响。46 例失眠障碍患者被随机分配到认知行为疗法治疗失眠(CBT-I;n=23)或候补对照组(n=23)。与假设相反,尽管失眠治疗成功(d=1.3),但意向治疗分析并未显示出对心血管疾病早期标志物的任何显著治疗效果(d=0.0-0.6)。讨论了这些阴性结果的潜在方法学和概念性原因。未来的研究可能包括更大的、有心血管疾病风险的样本量,并关注其他心血管标志物。

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