Department of Psychiatry, Zhengzhou University First Affiliated Hospital, Zhengzhou, 450052, Henan, People's Republic of China.
Department of Respiratory, Zhengzhou University First Affiliated Hospital, Zhengzhou, 450052, Henan, China.
Sleep Breath. 2021 Dec;25(4):2213-2219. doi: 10.1007/s11325-021-02350-y. Epub 2021 Mar 23.
The outbreak of Coronavirus Disease-2019 (COVID-19) caused great psychological distress often with comorbid insomnia. Insomnia is common in patients with COVID-19 admitted to mobile cabin hospitals. Insomnia may lead to immune dysfunction, a condition not conducive to recovery from COVID-19. The use of sedative-hypnotic drugs is limited by their inhibitory effect on the respiratory system. A paucity of research is available regarding psychotherapy interventions to improve insomnia symptoms among patients with COVID-19. In the general population, sleep problems are more common in women than in men; insomnia in women patients requires special attention. The aim of this study was to develop simplified-cognitive behavioral therapy for insomnia (S-CBTI) for patients with COVID-19 and comorbid insomnia symptoms and to verify its effectiveness through a self-control trial. A second aim was to compare the effectiveness of S-CBTI between acute and chronic insomnia among women with COVID-19 and comorbid insomnia symptoms in Wuhan Jianghan Cabin Hospital.
S-CBTI consisted of education on COVID-19 and sleep hygiene, stimulus control, sleep restriction, and self-suggestion relaxation training over a period of two consecutive weeks. Of 67 women, 66 completed psychological intervention and baseline and post-intervention assessments. There were 31 women with acute insomnia and 35 with chronic insomnia. The Insomnia Severity Index (ISI) score and self-compiled sleep data were assessed at baseline and post-intervention, and subjective sleep evaluations were assessed at days 4, 7, 12, and 14.
The ISI score, sleep latency, night sleep time, and sleep efficiency were statistically significantlly improved from baseline to post-intervention by paired T-test. After the intervention, the mean ISI score of the acute insomnia group was lower than that of the chronic insomnia group. The reduction of the ISI score and the improvement of sleep time from baseline to post-intervention in the acute insomnia group were greater than those in the chronic insomnia group. Utilization of sedative-hypnotic drugs in the acute insomnia group was less than that in the chronic insomnia group, and the difference was statistically significant.
S-CBTI can improve the insomnia symptoms of women with COVID-19 in mobile cabin hospitals, especially for stress-related acute insomnia.
2019 年冠状病毒病（COVID-19）的爆发导致了巨大的心理困扰，通常伴有合并失眠症。在移动方舱医院住院的 COVID-19 患者中，失眠症很常见。失眠症可能导致免疫功能障碍，不利于 COVID-19 的康复。镇静催眠药物的使用受到其对呼吸系统抑制作用的限制。针对 COVID-19 患者改善失眠症状的心理治疗干预措施研究甚少。在普通人群中，女性比男性更容易出现睡眠问题；女性患者的失眠症需要特别关注。本研究旨在为 COVID-19 合并失眠症的患者开发简化认知行为疗法治疗失眠症（S-CBTI），并通过自身对照试验验证其有效性。第二个目的是比较 S-CBTI 在武汉江汉方舱医院 COVID-19 合并失眠症的急性和慢性失眠症女性患者中的疗效。
S-CBTI 包括 COVID-19 和睡眠卫生教育、刺激控制、睡眠限制和自我暗示放松训练，持续两周。67 名女性中，66 名完成了心理干预和基线及干预后评估。其中急性失眠 31 例，慢性失眠 35 例。采用失眠严重程度指数（ISI）评分和自编睡眠数据在基线和干预后进行评估，主观睡眠评估在第 4、7、12 和 14 天进行。
采用配对 t 检验，ISl 评分、睡眠潜伏期、夜间睡眠时间和睡眠效率从基线到干预后均有统计学意义。干预后，急性失眠组的平均 ISI 评分低于慢性失眠组。急性失眠组从基线到干预后的 ISI 评分下降和睡眠时间改善均大于慢性失眠组。急性失眠组镇静催眠药物的使用率低于慢性失眠组，差异有统计学意义。
S-CBTI 可改善方舱医院 COVID-19 女性患者的失眠症状，特别是应激相关的急性失眠症。
