乌克兰战乱地区基于认知行为疗法的非指导性、移动睡眠干预：一项可行性研究。

Non-guided, mobile, CBT-I-based sleep intervention in War-torn Ukraine: A feasibility study.

作者信息

Kurapov Anton, Blechert Jens, Hinterberger Alexandra, Topalidis Pavlos, Schabus Manuel

机构信息

Laboratory for Sleep, Cognition and Consciousness Research, Paris Lodron University of Salzburg, Austria.

Department of Experimental and Applied Psychology, Faculty of Psychology, Taras Shevchenko National University of Kyiv, Ukraine.

出版信息

PLoS One. 2025 May 27;20(5):e0310070. doi: 10.1371/journal.pone.0310070. eCollection 2025.

DOI:10.1371/journal.pone.0310070

PMID:40424239

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12111256/

Abstract

BACKGROUND

War conditions can severely impact sleep and mental health at the population level, especially in the conflicts of such tremendous scale as in Ukraine. The aim of this research was to study whether a mobile, unguided Cognitive Behavioral Therapy-based Intervention for sleep problems, Sleep2, is feasible, acceptable, and potentially able to reduce mental health/sleep problems symptoms.

METHODS

A single-arm, open-label, uncontrolled pre-post evaluation study was conducted with 487 registered participants: 283 started, 160 (56.55%) finished, out of which 95 completed without an ambulatory heart rate (HR) sensor and 65 with. Assessments were conducted through online questionnaires and objective measurements via HR sensors. Besides feasibility and acceptability, outcome measures included symptoms in several mental health domains alongside self-reported and objectively reported sleep parameter.

RESULTS

Engagement with the Sleep2 app was high, achieving an 80.72% compliance rate, alongside high levels of feasibility and acceptance. Participants reported significant pre-post reductions in the severity of symptoms, with sleep problems decreasing by 22.60% (Cohen's d = 0.53), insomnia by 35.08% (d = 0.69), fear of sleep by 32.43% (d = 0.25), anxiety by 27.72% (d = 0.48), depression by 28.67% (d = 0.52), PTSD by 32.41% (d = 0.51), somatic symptoms by 24.52% (d = 0.51), and perceived stress by 17.90% (d = 0.39). Objective sleep measurements showed a significant reduction in sleep onset latency only.

CONCLUSION

The 'Sleep2Ukraine' program demonstrated high feasibility and acceptance, with significant improvements in subjective sleep and mental health measures among participants. However, given the study's uncontrolled design and reliance on self-selected participants, these findings should be considered preliminary. Randomized controlled trials are needed to establish efficacy. Nonetheless, the results highlight the potential of culturally adapted, scalable, mobile-based CBT-I interventions to address sleep and mental health needs in war-affected populations.

摘要

背景

战争状况会在人群层面严重影响睡眠和心理健康，尤其是在像乌克兰冲突这样规模巨大的冲突中。本研究的目的是探讨一种基于认知行为疗法的、针对睡眠问题的移动、非指导性干预措施Sleep2是否可行、可接受，以及是否有可能减轻心理健康/睡眠问题症状。

方法

对487名注册参与者进行了一项单臂、开放标签、非对照的前后评估研究：283人开始参与，160人（56.55%）完成，其中95人在没有动态心率（HR）传感器的情况下完成，65人使用了传感器。通过在线问卷和HR传感器进行客观测量来进行评估。除了可行性和可接受性外，结果指标还包括几个心理健康领域的症状以及自我报告和客观报告的睡眠参数。

结果

对Sleep2应用程序的参与度很高，依从率达到80.72%，同时具有很高的可行性和接受度。参与者报告称，前后症状严重程度有显著降低，睡眠问题减少了22.60%（科恩d值=0.53），失眠减少了35.08%（d值=0.69），对睡眠的恐惧减少了32.43%（d值=0.25），焦虑减少了27.72%（d值=0.48），抑郁减少了28.67%（d值=0.52），创伤后应激障碍减少了32.41%（d值=0.51），躯体症状减少了24.52%（d值=0.51），感知压力减少了17.90%（d值=0.39）。客观睡眠测量仅显示睡眠开始潜伏期有显著缩短。

结论

“Sleep2乌克兰”项目显示出很高的可行性和接受度，参与者的主观睡眠和心理健康指标有显著改善。然而，鉴于该研究的非对照设计以及对自我选择参与者的依赖，这些发现应被视为初步的。需要进行随机对照试验来确定疗效。尽管如此，结果凸显了经过文化调适、可扩展的基于移动设备的失眠认知行为疗法干预措施在满足受战争影响人群的睡眠和心理健康需求方面的潜力。