失眠认知行为疗法对酒依赖患者睡眠质量及情绪的影响

Effect of cognitive behavioral therapy for insomnia on sleep quality and mood in patients with alcohol dependence

目的探讨失眠的认知行为疗法对于酒依赖患者睡眠质量和抑郁、焦虑情绪等方面的影响,为临床提供参考。方法招募了于2017年5月-2018年12月期间杭州市第七人民医院收治的符合入组标准的酒依赖患者共66例,将其随机分为观察组和对照组各33例。对照组接受常规治疗和护理干预,观察组在此基础上进一步接受失眠的认知行为疗法干预,总干预时间持续4周。并分别在治疗前、治疗后评估2组患者的入睡时间、睡眠时间、睡眠效率、抑郁和焦虑情绪。结果 2组患者的人口学资料及基线PSQI评分、SDS评分、SAS评分差异均无统计学意义(P>0.05)。干预后,观察组入睡时间评分[(1.77±0.52)分vs.(2.21±0.67)分,P=0.004]、睡眠时间评分[(1.26±0.83)分vs.(1.72±0.95)分,P=0.040]、睡眠效率评分[(0.76±0.84)分vs.(1.26±0.75)分,P=0.013]及PSQI总分[(9.38±6.29)分vs.(13.54±6.85)分,P=0.013]、SDS评分[(36.81±7.76)分vs.(45.47±8.25)分,P<0.001]、SAS评分[(33.18±6.73)分vs.(42.26±11.48)分,P<0.001]均低于对照组,2组评分差异均有统计学意义(均P<0.05)。结论失眠的认知行为疗法可有效改善酒依赖患者的睡眠质量、抑郁和焦虑情绪,减少其入睡时间,增加总睡眠时间,提高睡眠效率,改善睡眠质量,有助于患者病情恢复。

Objective To explore the effects of cognitive behavioral therapy for insomnia on sleep quality, depression and anxiety in patients with alcohol-induced mental and behavioral disorders. Methods A total of 66 patients with alcohol-induced mental and behavioral disorders who met the inclusion criteria were enrolled from May 2017 to December 2018, and randomized into observation group(33 patients) and control group(33 patients). Patients in the control group received routine treatment and nursing intervention. On this basis, the observation group further accepted cognitive behavioral therapy intervention for insomnia. The total intervention time lasted for 4 weeks. The time of sleep onset, total sleep time, sleep efficiency, sleep quality, depression and anxiety of the two groups were measured before and after treatment. Results There were no significant differences in demographic data and baseline Pittsburgh Sleep Quality Index scores, depression self-rating scale scores and anxiety self-rating scale scores between the two groups(P>0.05). After 4 weeks of intervention, the observation group’s time of sleep onset(1.77±0.52 vs. 2.21±0.67, P=0.004), total sleep time(1.26±0.83 vs. 1.72±0.95, P=0.040), sleep efficiency(0.76±0.84 vs. 1.26±0.75, P=0.013), Pittsburgh Sleep Quality Index questionnaire score(observation 9.38±6.29 vs. 13.54±6.85, P=0.013), depression self-rating scale score(36.81±7.76 vs. 45.47±8.25, P<0.001), and anxiety self-rating scale score(33.18±6.73 vs. 42.26±11.48, P<0.001) were significant lower than those of the control group(all P<0.05). Conclusion Cognitive behavioral therapy for insomnia can effectively improve the quality of sleep, depression and anxiety in patients with mental and behavioral disorders caused by alcohol, reduce the sleep time of patients alcohol-induced mental and behavioral disorders, increase their total sleep time, improve their sleep efficiency, improve sleep quality, and help patients recover from their illness.