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失眠干预对癌症幸存者健康相关生活质量和心理健康结局的影响:一项随机对照试验

Health-related quality of life and mental health outcomes among cancer survivors in an insomnia intervention: a randomized controlled trial.

作者信息

Kwon Misol, Zhu Jingtao, Wilding Gregory E, Larkin Karen, Gehrman Philip R, Dickerson Suzanne S

机构信息

Division of Sleep Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, United States.

University of Pennsylvania, School of Nursing, Philadelphia, PA, United States.

出版信息

Ann Behav Med. 2025 Jan 4;59(1). doi: 10.1093/abm/kaae096.

Abstract

BACKGROUND

While brief behavioral therapy for insomnia (BBTI) has shown promising results in improving sleep outcomes, its effects on health-related quality of life (HRQOL) and mental health among cancer survivors have been understudied.

PURPOSE

To evaluate the effect of BBTI on HRQOL and mental health outcomes among cancer survivors, relative to an attention control group receiving a healthy eating program (HEP), over periods from baseline to 12 months and from 3 to 12 months.

METHODS

A sample of 132 cancer survivors with insomnia symptoms (Mage: 63.7 ± 10 years; 55.3% female) was assessed at baseline, with the final analytical sample of 121 (BBTI = 62, HEP = 59). Self-reported HRQOL, mood disturbance, depression, and anxiety at baseline, 3 months, and 12 months were examined. A multivariate linear model using least squares means evaluated within- and between-group differences.

RESULTS

No significant differences in outcome variables were found between the randomized groups at any time point. Both groups showed significant improvements in total HRQOL, mood disturbance, and anxiety symptoms from baseline to 12 months. Only the BBTI group demonstrated a significant reduction in depressive symptoms within the group, an effect not observed in the HEP group. The most noticeable changes occurred within the first 3 months, with no statistically significant differences from 3 to 12 months within or between groups.

CONCLUSION

While both randomized groups showed improvements in total HRQOL, mood, and anxiety symptoms, only BBTI produced significant within-group improvements in depressive symptoms over 12 months.

CLINICAL TRIAL REGISTRATION

https://ClinicalTrials.gov, NCT03810365.

摘要

背景

虽然失眠简短行为疗法(BBTI)在改善睡眠结果方面已显示出有前景的效果,但其对癌症幸存者健康相关生活质量(HRQOL)和心理健康的影响尚未得到充分研究。

目的

评估相对于接受健康饮食计划(HEP)的注意力控制组,BBTI在基线至12个月以及3至12个月期间对癌症幸存者HRQOL和心理健康结果的影响。

方法

对132名有失眠症状的癌症幸存者样本(平均年龄:63.7±10岁;55.3%为女性)在基线时进行评估,最终分析样本为121人(BBTI组=62人,HEP组=59人)。对基线、3个月和12个月时自我报告的HRQOL、情绪困扰、抑郁和焦虑情况进行检查。使用最小二乘均值的多元线性模型评估组内和组间差异。

结果

在任何时间点,随机分组的两组在结果变量上均未发现显著差异。两组从基线到12个月在总HRQOL、情绪困扰和焦虑症状方面均有显著改善。仅BBTI组在组内抑郁症状有显著减轻,HEP组未观察到这种效果。最明显的变化发生在最初3个月内,组内和组间从3至12个月均无统计学显著差异。

结论

虽然两个随机分组在总HRQOL、情绪和焦虑症状方面均有改善,但只有BBTI在12个月内使组内抑郁症状有显著改善。

临床试验注册

https://ClinicalTrials.gov,NCT03810365。

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