Madigan Army Medical Center, Tacoma, WA 98431, USA.
Mil Med. 2023 Aug 29;188(9-10):2856-2861. doi: 10.1093/milmed/usac264.
Insomnia and obstructive sleep apnea are common conditions among military service members, with high rates of comorbidity. Although cognitive behavioral therapy for insomnia (CBT-I) has been established as an effective treatment for insomnia, it is unclear whether or not CBT-I is effective among service members with comorbid insomnia and obstructive sleep apnea.
This retrospective, observational study examined insomnia outcomes among a group of service member patients (N = 73) with comorbid insomnia and obstructive sleep apnea. All patients received individual CBT-I in a specialty sleep clinic at a military treatment facility. Seven outcomes associated with insomnia were evaluated before and after treatment.
On average, patients showed significant improvement in sleep onset latency, wake after sleep onset, sleep efficiency, number of awakenings, and symptoms reported on the Insomnia Severity Index. Twenty-six percent of patients showed clinically significant improvement in reported insomnia symptoms.
These results suggest that CBT-I may be effective in treating military service members with comorbid insomnia and obstructive sleep apnea. Despite the limitations of data collected in a clinical setting, consistent findings across five of the seven outcome measures provide good evidence that this treatment can be implemented in military settings.
失眠和阻塞性睡眠呼吸暂停在军人中很常见，且二者常合并存在。虽然认知行为疗法（CBT-I）已被确立为失眠的有效治疗方法，但 CBT-I 是否对合并失眠和阻塞性睡眠呼吸暂停的军人有效尚不清楚。
本回顾性观察研究调查了在军事治疗设施的专业睡眠诊所接受个体 CBT-I 的一组合并失眠和阻塞性睡眠呼吸暂停的军人患者（N=73）的失眠结局。在治疗前后评估了与失眠相关的 7 个结局。
平均而言，患者的入睡潜伏期、睡眠后觉醒时间、睡眠效率、觉醒次数和失眠严重程度指数报告的症状均有显著改善。26%的患者报告的失眠症状有临床显著改善。
这些结果表明，CBT-I 可能对合并失眠和阻塞性睡眠呼吸暂停的军人有效。尽管存在从临床环境中收集数据的局限性，但七个结局指标中的五个都有一致的发现，这为该治疗方法可以在军事环境中实施提供了有力证据。
