远程医疗与失眠症：全面系统综述与荟萃分析。

Telemedicine and insomnia: a comprehensive systematic review and meta-analysis.

机构信息

Department of Medicine, Pulmonary, Critical Medicine and Sleep Medicine, Baylor College of Medicine, Houston, TX, United States.

Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

Sleep Med. 2022 Feb;90:117-130. doi: 10.1016/j.sleep.2022.01.016. Epub 2022 Jan 25.

DOI:10.1016/j.sleep.2022.01.016

PMID:35151065

Abstract

BACKGROUND

Telemedicine has been introduced as a new and effective method in dealing with public health challenges, improving access to health care, and reducing healthcare costs in today's world. Insomnia is the most common sleep disorder that can be managed with cognitive behavioural therapy, however, access to skilled therapists is an issue. Telemedicine improves access to care and thus, it may facilitate management of insomnia. The aim of this study was to assess whether telemedicine can be as effective as traditional in person sleep medicine service for the diagnosis, follow-up, and treatment of insomnia.

METHODS

In this systematic review and meta-analysis, studies related to telemedicine and insomnia were identified and selected, using the keywords of telemedicine, insomnia, sleep disorder, treatment, non-pharmacological treatment. The international databases of Embase, ProQuest, ScienceDirect, Scopus, PubMed and Web of Science (WoS), and Google Scholar were searched without a lower time limit, and until July 12, 2021. Data were analysed within the Comprehensive Meta-Analysis (version 2) software, and the significance level of the test was considered P ˂ 0.05.

RESULTS

A systematic review of 16 selected studies showed that telemedicine interventions have a positive effect on improving insomnia in different groups. The meta-analysis was performed on 2 studies. Based on the results, CBTI interventions based on telemedicine have a greater effect on improving chronic insomnia than face to face CBTI with an average difference of 2.05 ± 0.66 based on the random effects model. Moreover, the difference between the mean in the telemedicine intervention group and the non-intervention group was 0.65 ± 0.19, which shows the positive effect of the telemedicine intervention.

CONCLUSION

The use of telemedicine in treatment of insomnia not only accelerates access to sleep services, but can also improve the efficiency of health services in terms of time and cost, as well as therapeutic effects.

摘要

背景

远程医疗作为一种新的有效方法，在当今世界，它可以提高医疗保健的可及性、降低医疗成本，并应对公共卫生挑战。失眠是最常见的睡眠障碍，可以通过认知行为疗法进行管理，然而，获得熟练的治疗师是一个问题。远程医疗可以改善获得护理的机会，因此，它可能有助于管理失眠。本研究的目的是评估远程医疗是否可以像传统的面对面睡眠医学服务一样，对失眠的诊断、随访和治疗有效。

方法

在本系统评价和荟萃分析中，使用远程医疗、失眠、睡眠障碍、治疗、非药物治疗等关键词，检索了与远程医疗和失眠相关的研究，并进行了筛选。检索了国际数据库 Embase、ProQuest、ScienceDirect、Scopus、PubMed 和 Web of Science（WoS）以及 Google Scholar，没有时间下限，检索时间截至 2021 年 7 月 12 日。使用 Comprehensive Meta-Analysis（版本 2）软件对数据进行分析，检验的显著性水平设为 P<0.05。

结果

对 16 项选定研究进行系统评价显示，远程医疗干预措施对改善不同人群的失眠有积极影响。对 2 项研究进行了荟萃分析。基于结果，基于远程医疗的 CBTI 干预对改善慢性失眠的效果优于面对面 CBTI，基于随机效应模型，平均差异为 2.05±0.66。此外，远程医疗干预组与非干预组之间的差异为 0.65±0.19，这表明远程医疗干预的积极效果。