Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, UCLA Insomnia Clinic, Cousins Center for Psychoneuroimmunology, University of California Los Angeles, 300 Medical Plaza Driveway, Los Angeles, CA, 90025, USA; Cedars Sinai Medical Center, 8700 Beverly Blvd #2900A, Los Angeles, CA, 90048, USA.
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, UCLA Insomnia Clinic, Cousins Center for Psychoneuroimmunology, University of California Los Angeles, 300 Medical Plaza Driveway, Los Angeles, CA, 90025, USA.
Sleep Med Clin. 2023 Mar;18(1):95-111. doi: 10.1016/j.jsmc.2022.10.004.
Cognitive behavioral therapy for insomnia (CBT-I) is the universally recommended treatment of choice for insomnia disorder based on its safety and posttreatment durability of benefit. However, CBT-I does not help all patients achieve remission. The second most evidence-based treatment, hypnotic pharmacotherapy (PCT), does not resolve perpetuating factors of insomnia, resulting in potential waning of benefit and dependence. This article presents a rationale that supports consideration of hypnotic augmentation of CBT-I (COMB), along with a review of select randomized controlled trials relevant to clinical decision-making.
认知行为疗法治疗失眠症（CBT-I）是失眠障碍的首选治疗方法，因其安全性和治疗后获益的持久性而得到广泛推荐。然而，CBT-I 并不能帮助所有患者实现缓解。第二种最具循证医学证据的治疗方法，催眠药物治疗（PCT），并不能解决失眠的持续因素，从而导致潜在的获益减弱和依赖性。本文提出了一个支持考虑 CBT-I 催眠增强（COMB）的理由，并回顾了与临床决策相关的一些随机对照试验。
