失眠认知行为治疗联合催眠对失眠和睡眠信念及态度的临床疗效

Clinical Effect of Cognitive BehavioRTherapy foRInsomnia(CBT-I)Combined with Hypnosis on Insomnia Symptoms and Sleep Belief and Attitude.

目的探讨失眠认知行为治疗(CBT-I)联合催眠对慢性失眠患者失眠症状和睡眠信念及态度的治疗效果。方法选择我院睡眠心理科2018年9月至2019年12月收治的慢性失眠患者共58例,按照随机数表法将其分为试验组与对照组,每组29例。分别给予6周团体CBT-I治疗联合催眠和传统团体CBT-I治疗,在干预前、干预结束后即刻、干预结束后3个月,采用匹兹堡睡眠质量指数量表(PSQI)、失眠严重指数(ISI)及睡眠个人信念和态度量表(DBAS)用于评估失眠症状和睡眠的信念及态度。结果干预结束后即刻,试验组患者的PSQI、ISI及DBAS得分低于对照组,差异均有统计学意义(均P<0.01);干预结束后3个月,试验组患者的PSQI、ISI及DBAS得分低于对照组,差异均有统计学意义(均P<0.01);试验组干预结束后3个月PSQI和DBAS得分高于干预后即刻,差异有统计学意义(P<0.05);试验组干预结束后3个月ISI得分与干预后即刻差异无统计学意义(P>0.05);对照组干预结束后3个月ISI和DBAS得分高于干预结束后即刻,差异有统计学意义(P<0.05);两组干预后3个月PSQI得分较干预后即刻无显著变化(P>0.05)。结论CBT-I治疗联合催眠较传统团体CBT-I治疗对失眠症状、睡眠状态及不良睡眠信念及态度有更好的改善效果,可进一步临床推广。

Objective To explore the effect of cognitive behavior therapy for insomnia(CBT-I)combined with hypnosis on insomnia symptoms,insomnia severity,beliefs and attitudes about sleep in patients with chronic insomnia.Methods The chronic insomnia patients(n=58)recruited from the department of sleep and neurology psychological in daping hospital of army medical university during September 2018 to December 2019 were divided into experimental group(n=29)and control group(n=29)according to random number table.Experimental group received a 6-week-setting group cognitive behavior therapy for insomnia(CBT-I)combined with hypnosis while control group underwent group CBT-I for the same time.Assessment of pittsburg sleep quality index(PSQI),insomnia severity Index(ISI),dysfunctional beliefs and attitudes about sleep questionnaire(DBAS)was taken before intervention,after intervention and 3 months after intervention.Results After the intervention,the PSQI,ISI and DBAS scores were lower in the experimental group than that in the control group,and the differences were statistically significant(P<0.01).The scores of PSQI,ISI and DBAS were also lower in the experimental group than that in the control goup 3 months after intervention,and the differences were statistically significant(P<0.01);Three months after intervention,the PSQI and DBAS scores of experimental group were higher than that after the intervention(P<0.05);there was no significant difference of ISI scores in the experimental group between 3 months after intervention and after the intervention(P>0.05);the ISI and DBAS scores of the control group at 3 months afteRintervention was higher than that after the intervention,and the difference was statistically significant(P<0.05);there was no significant difference in PSQI scores of the control group between 3 months after intervention and after the intervention(P>0.05).Conclusion The improvement of sleep with CBT-I combined with hypnotic therapy is more effective than traditional CBT-I therapy for insomnia,undesirable sleep condition and bad sleep beliefs and attitudes,so it is worthy to recommend its clinical use.