网络认知行为治疗对失眠症患者睡眠质量和客体及空间工作记忆功能影响

Effect of Internet-based cognitive behavioral therapy on sleeping quality,object and spatial working memory in patients with insomnia

目的失眠患者常出现疲劳、情绪失调和记忆力差等表现,严重影响其生活质量。本研究探讨网络认知行为治疗对失眠症患者疗效及对患者客体、空间工作记忆功能影响。方法选择2017-01-01-2018-12-31沈阳医学院附属第二医院收治的120例失眠症患者作为研究对象,按照组间匹配的原则分为观察组和对照组,各60例。均采用以认知行为治疗为主的治疗方案,持续8周,对照组给予传统门诊干预,观察组给予网络认知行为干预。比较两组治疗前后多导睡眠图特征、治疗期间匹兹堡睡眠质量指数(Pittsburgh sleep qualityindex,PSQI)变化情况、客体及空间工作记忆功能。结果治疗8周后,观察组总睡眠时间为(408.41±53.68)min,长于对照组的(385.89±61.12)min,t=2.085,P=0.039;睡眠效率为(86.28±10.32)%,高于对照组的(82.12±9.29)%,t=2.244,P=0.027。观察组睡眠潜伏期为(9.85±3.30)min,短于对照组的(13.75±5.19)min,t=4.808,P<0.001;觉醒时间为(73.24±25.18)min,短于对照组的(88.73±38.22)min,t=2.564,P=0.012;空间工作记忆测试中反应时间为(1185.93±185.76)ms,短于对照组的(1295.27±213.64)ms,t=2.909,P=0.004。客体工作记忆测试中错误数(r=0.520,P<0.05)和空间工作记忆测试中反应时间的改善效果(r=0.564,P<0.05)均与PSQI改善效果呈正相关。结论网络认知行为治疗能够更有效地改善失眠症患者睡眠质量及空间工作记忆功能,这可能与其能够更好地改善PSQI有关。

OBJECTIVE Patients with insomnia often experience symptoms such as fatigue,emotional disorders and poor memory,which seriously affect their quality of life.This study explores the effects of network cognitive behavior therapy on patients with insomnia and the effects on patient objects and spatial working memory function.METHODS A total of 120 patients with insomnia treated from January 1,2017 to December 31,2018 in Second Hospital Affiliated to Shenyang Medical College were divided into two groups according to the principle of matching between groups,60 cases each.All were treated with cognitive-behavioral therapy for 8 weeks.The control group was given traditional outpatient intervention,the observation group was given online cognitive-behavioral intervention.The characteristics of polysomnography before and after treatment,changes in Pittsburgh sleep quality index(PSQI),object and spatial working memory function were compared between the two groups before and after treatment.RESULTS After 8 weeks of treatment,the total sleep time in the observation group was(408.41±53.68)min,which was longer than that in the control group(385.89±61.12)min,t=2.085,P=0.039.The sleep efficiency was(86.28±10.32)%,which was higher than the control group(82.12±9.29)%,t=2.244,P=0.027.The sleep latency of the observation group was(9.85±3.30)min,shorter than that of the control group(13.75±5.19)min,t=4.808,P<0.001;the awake time was(73.24±25.18)min,shorter than that of the control group(88.73±38.22)min,t=2.564,P=0.012;the response time in the spatial working memory test was(1185.93±185.76)ms,which was shorter than that of the control group(1295.27±213.64)ms,t=2.909,P=0.004.The number of errors in the object working memory test(r=0.520,P<0.05)and the effect of improving the response time in the space working memory test(r=0.564,P<0.05)were positively related to the PSQI improvement effect.CONCLUSION Cognitive behavioral therapy can improve sleep quality and spatial working memory function of patients with insomnia more effectively,which may be related to its ability to better improve PSQI.