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互联网干预对老年人失眠的影响:对抑郁和焦虑症状的二次分析。

Effects of an internet-delivered insomnia intervention for older adults: A secondary analysis on symptoms of depression and anxiety.

机构信息

Center for Behavioral Health and Technology, University of Virginia, PO Box 801075, 22908, Charlottesville, VA, USA.

出版信息

J Behav Med. 2022 Oct;45(5):728-738. doi: 10.1007/s10865-022-00353-y. Epub 2022 Aug 6.

Abstract

OBJECTIVE

To test whether an Internet-delivered cognitive behavioral therapy for insomnia (CBT-I) program for older adults attenuates symptoms of depression and anxiety.

METHODS

Adults aged ≥ 55 with insomnia were randomized to SHUTi-OASIS (Sleep Healthy Using the Internet for Older Adult Sufferers of Insomnia and Sleeplessness; N = 207) or Patient Education (PE; N = 104). Depression and anxiety were assessed (HADS-D and HADS-A, respectively) at baseline, post-assessment, and 6- and 12-month follow-ups.

RESULTS

Multilevel modeling of HADS-D showed a condition by time interaction (F[3,779] = 3.23, p = .02): SHUTi-OASIS participants reported lower symptoms than PE at post-assessment. There was no such interaction effect for HADS-A (F[3,779] = 2.12, p = .10). Generalized linear modeling showed no moderation of effects by baseline symptom severity.

CONCLUSIONS

Participants randomized to Internet-delivered CBT-I showed stable depression and anxiety across time, while control participants' depressive symptoms briefly increased. CBT-I may help prevent development or worsening of psychological distress among older adults with insomnia.

TRIAL REGISTRATION

[Registered at ClinicalTrials.gov; identifier removed for anonymity].

摘要

目的

测试针对老年人的互联网认知行为疗法失眠(CBT-I)方案是否能减轻抑郁和焦虑症状。

方法

年龄在 55 岁及以上、有失眠症状的成年人被随机分配到 SHUTi-OASIS(通过互联网为老年失眠和失眠患者提供健康睡眠;n = 207)或患者教育(PE;n = 104)组。在基线、评估后以及 6 个月和 12 个月随访时,分别评估抑郁和焦虑(分别用 HADS-D 和 HADS-A 评估)。

结果

对 HADS-D 的多层次建模显示条件与时间的交互作用(F[3,779] = 3.23,p =.02):在评估后,SHUTi-OASIS 组的症状比 PE 组轻。HADS-A 没有这种交互作用(F[3,779] = 2.12,p =.10)。广义线性模型显示,基线症状严重程度对效果没有调节作用。

结论

随机接受互联网提供的 CBT-I 的参与者在整个时间内保持稳定的抑郁和焦虑,而对照组参与者的抑郁症状短暂增加。CBT-I 可能有助于预防老年失眠者心理困扰的发展或恶化。

试验注册

[在 ClinicalTrials.gov 注册;为了匿名,标识符已删除]。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fed2/9362578/56d449a58f7e/10865_2022_353_Fig1_HTML.jpg

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