Neurology Medicine Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
Ann Palliat Med. 2021 Oct;10(10):10684-10696. doi: 10.21037/apm-21-2387.
The treatment of insomnia mainly includes drug therapy and non-drug therapy (cognitive behavioral therapy [CBT]). Traditional face-to-face CBT is affected by factors such as location, time, and treatment cost, making the treatment impossible to implement effectively. With the continuous development of network technology, internet-based CBT (ICBT) has been widely used due to the advantages of time and location.
It searched the China National Knowledge Internet (CNKI) database (1979-Apr 2021), China Biomedical Literature Database (1994-Apr 2021), Cochrane Library (2005-Apr 2021), Medline (1948-Apr 2021), and Embase (Jan 1966-Apr 2021). Chinese and English databases were searched using the following terms: internet-based cognitive behavioral therapy, cognitive behavioral therapy, sleep problems, and sleep disorders. Meta-analysis was performed using RevMan 5.3 and Stata SE 12.0 software provided by the Cochrane collaboration.
A total of 14 randomized controlled trials were included in this study. Of these, 10 described the correct random allocation method, 6 described the allocation scheme in detail, and 1 article used the blind method. Sleep onset latency after ICBT was much shorter than that of the control group [mean difference (MD): -12.27, 95% confidence interval (CI): -16.43 to -9.90, P<0.01]. Total sleep time after ICBT was much longer than that of the control group (MD: 38.67, 95% CI: 34.70-42.65, P<0.01). Sleep efficacy after ICBT was significantly higher in contrast with the control group (MD: 13.28, 95% CI: 10.49-16.06, P<0.01). Anxiety and depression levels after the ICBT were significantly lower than those in the control group (P<0.01).
Meta-analysis was adopted to confirm that ICBT can greatly improve the sleep parameters of patients with insomnia, and it was found to have a relieving effect on patients with anxiety and depression.
失眠的治疗主要包括药物治疗和非药物治疗（认知行为疗法[CBT]）。传统的面对面 CBT 受到地点、时间和治疗费用等因素的影响，使得治疗无法有效实施。随着网络技术的不断发展，基于互联网的 CBT（ICBT）由于时间和地点的优势而得到了广泛应用。
检索中国知网（CNKI）数据库（1979 年 4 月-2021 年）、中国生物医学文献数据库（1994 年 4 月-2021 年）、Cochrane 图书馆（2005 年 4 月-2021 年）、Medline（1948 年 4 月-2021 年）和 Embase（1966 年 1 月-2021 年 4 月）。中文和英文数据库均使用以下术语进行检索：基于互联网的认知行为疗法、认知行为疗法、睡眠问题和睡眠障碍。使用 Cochrane 协作提供的 RevMan 5.3 和 Stata SE 12.0 软件进行 Meta 分析。
本研究共纳入 14 项随机对照试验。其中，10 项描述了正确的随机分配方法，6 项详细描述了分配方案，1 项文章使用了盲法。ICBT 后入睡潜伏期明显短于对照组[均数差（MD）：-12.27，95%置信区间（CI）：-16.43 至-9.90，P<0.01]。ICBT 后总睡眠时间明显长于对照组（MD：38.67，95%CI：34.70-42.65，P<0.01）。ICBT 后睡眠效率明显高于对照组（MD：13.28，95%CI：10.49-16.06，P<0.01）。ICBT 后焦虑和抑郁水平明显低于对照组（P<0.01）。
采用 Meta 分析确认 ICBT 可显著改善失眠患者的睡眠参数，并发现其对焦虑和抑郁患者有缓解作用。
