Bai Nan, Yin Min
School of Nursing, Lanzhou University, Lanzhou, China; Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China.
School of Nursing, Lanzhou University, Lanzhou, China.
Sleep Med. 2024 Dec;124:627-636. doi: 10.1016/j.sleep.2024.10.030. Epub 2024 Oct 28.
Despite the effectiveness of digital cognitive behavior therapy for insomnia (dCBT-I) in treating comorbid insomnia and depression, its accessibility and high dropout rates among adolescents and young adults remain significant limitations. A potential solution could be nurse-led dCBT-I. This study evaluates the feasibility and efficacy of nurse-led dCBT-I in reducing insomnia symptoms and improving mood in adolescents and young adults with depression.
Our objective was to evaluate the feasibility and effectiveness of a nurse-led dCBT-I in reducing insomnia severity among adolescents and young adults with depression.
A parallel-group randomized controlled trial involved 40 adolescents and young adults aged 14 to 24 with major depressive disorder and insomnia. They were assigned to receive either a nurse-led 6-week dCBT-I or usual care. The study evaluated outcomes such as insomnia severity, depression severity, and sleep parameters. Measurements were taken at baseline, immediately after the intervention (6 weeks), and during a follow-up at 18 weeks.
The intention-to-treat analysis was performed using a generalized linear mixed model (GLMM). Results indicated that, compared to the control group, participants in the intervention group exhibited a significant reduction in insomnia severity at the 18-week follow-up, with a large effect size (Cohen's d = -0.965, p < 0.001). Additionally, the intervention group demonstrated a significant decrease in depression severity both at the end of the intervention (Cohen's d = -0.686, p = 0.001) and at the 18-week follow-up (Cohen's d = -0.508, p = 0.011), indicating a medium effect size.
Nurse-led dCBT-I is an effective treatment for adolescents and young adults with depression and insomnia.
尽管数字认知行为疗法治疗失眠（dCBT - I）在治疗共病性失眠和抑郁症方面有效，但其在青少年和青年中的可及性以及高辍学率仍是显著限制。一个潜在的解决方案可能是以护士为主导的dCBT - I。本研究评估以护士为主导的dCBT - I在减轻青少年和青年抑郁症患者的失眠症状及改善情绪方面的可行性和疗效。
我们的目标是评估以护士为主导的dCBT - I在降低青少年和青年抑郁症患者失眠严重程度方面的可行性和有效性。
一项平行组随机对照试验纳入了40名年龄在14至24岁之间、患有重度抑郁症和失眠的青少年和青年。他们被分配接受为期6周的以护士为主导的dCBT - I或常规护理。该研究评估了失眠严重程度、抑郁严重程度和睡眠参数等结果。在基线、干预结束后即刻（6周）以及18周的随访期间进行测量。
使用广义线性混合模型（GLMM）进行意向性分析。结果表明，与对照组相比，干预组参与者在18周随访时失眠严重程度显著降低，效应量较大（科恩d值 = - 0.965，p < 0.001）。此外，干预组在干预结束时（科恩d值 = - 0.686，p = 0.001）和18周随访时（科恩d值 = - 0.508，p = 0.011）抑郁严重程度均显著降低，表明效应量中等。
以护士为主导的dCBT - I是治疗青少年和青年抑郁症及失眠的有效疗法。
