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改善 HIV 感染者和慢性疼痛患者的睡眠:失眠简要行为治疗的初步研究。

Improving Sleep in People with HIV and Chronic Pain: A Pilot Study of Brief Behavioral Treatment for Insomnia.

机构信息

Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, USA.

Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.

出版信息

Behav Sleep Med. 2024 Nov-Dec;22(6):949-959. doi: 10.1080/15402002.2024.2396820. Epub 2024 Sep 8.

Abstract

OBJECTIVES

Insomnia and chronic pain are common symptoms in people with HIV. Poor sleep has been associated with chronic pain. While cognitive behavioral therapy for insomnia improves insomnia in clinical populations, there are barriers to people with HIV accessing treatment including the lack of trained providers and lengthy sessions. Only one study has examined the efficacy of brief behavioral treatment for insomnia (BBTI) in people with HIV. This study examined BBTI effects on sleep and pain in people with HIV.

METHODS

Ten adults with HIV and chronic pain completed a 4-week, telephone-delivered BBTI treatment. A control group (n = 10) completed a brief mindfulness training (BMT). The Insomnia Severity Index and Brief Pain Inventory were used to assess insomnia severity and pain outcomes, respectively.

RESULTS

There was a significant interaction between intervention and time on insomnia severity, F (2,14) = 5.7,  = .02, partial η = 0.45). The BBTI group demonstrated significant improvements in insomnia severity from pre- to post-intervention ( < .001) and from pre-intervention to one-month post-intervention ( = .001) compared to the BMT group. There was a significant interaction between intervention and time on pain interference, F (1,18) = 4.9,  = .02, partial η = 0.27). The BBTI group demonstrated a significant decrease in pain interference from pre- to post-intervention ( < .001) compared to the BMT group.

CONCLUSIONS

This pilot study demonstrated that BBTI improved insomnia in people with HIV for up to one-month post-treatment. Novel preliminary evidence suggests that BBTI may also improve pain outcomes in people with HIV.

摘要

目的

失眠和慢性疼痛是艾滋病毒感染者常见的症状。睡眠质量差与慢性疼痛有关。认知行为疗法治疗失眠症(CBT-I)可以改善临床人群的失眠症,但艾滋病毒感染者在接受治疗方面存在障碍,包括缺乏经过培训的治疗师和冗长的疗程。只有一项研究检查了针对艾滋病毒感染者的简短行为治疗失眠症(BBTI)的疗效。本研究检查了 BBTI 对艾滋病毒感染者睡眠和疼痛的影响。

方法

10 名患有 HIV 和慢性疼痛的成年人完成了为期 4 周的电话提供的 BBTI 治疗。对照组(n=10)完成了简短的正念训练(BMT)。使用失眠严重程度指数和简明疼痛量表分别评估失眠严重程度和疼痛结果。

结果

在失眠严重程度方面,干预和时间之间存在显著的交互作用,F(2,14)=5.7,  = .02,部分 η =0.45)。与 BMT 组相比,BBTI 组在干预前后( < .001)和从干预前到干预后一个月( = .001)的失眠严重程度均有显著改善。在疼痛干扰方面,干预和时间之间存在显著的交互作用,F(1,18)=4.9,  = .02,部分 η =0.27)。与 BMT 组相比,BBTI 组在干预前后( < .001)的疼痛干扰显著降低。

结论

这项初步研究表明,BBTI 可改善 HIV 感染者的失眠症,最长可达治疗后一个月。初步的新证据表明,BBTI 还可能改善 HIV 感染者的疼痛结果。

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