Center for Behavioral Health and Technology, University of Virginia, PO Box 801075, 22908, Charlottesville, VA, USA.
J Behav Med. 2022 Oct;45(5):728-738. doi: 10.1007/s10865-022-00353-y. Epub 2022 Aug 6.
To test whether an Internet-delivered cognitive behavioral therapy for insomnia (CBT-I) program for older adults attenuates symptoms of depression and anxiety.
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.
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.
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.
[Registered at ClinicalTrials.gov; identifier removed for anonymity].
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。
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)。
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。
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。
[在 ClinicalTrials.gov 注册;为了匿名,标识符已删除]。