在线失眠认知行为治疗对慢性失眠症的干预效果

The effect of online cognitive behavioral therapy on chronic insomnia

目的探讨在线失眠认知行为治疗(eCBT-I)对慢性失眠症的干预效果。方法选取经过评估的慢性失眠患者78例入组,按照随机数字表法分为eCBT-I组(n=39)和对照组(n=39)。入组后两组均进行基线评估并记录第1周的睡眠日记,eCBT-I组予以4周eCBT-I课程,对照组不开通课程,仅提供睡眠卫生教育。第4周两组再次记录1周睡眠日记并进行失眠严重程度指数(ISI)评估。对eCBT-I组、对照组进行第1及4周的ISI及睡眠日记指标进行组间、组内前后比较,并以ISI<8为失眠痊愈指标进行疗效评估。结果eCBT-I组24例完成4周治疗,对照组22例完成了2次评估。4周治疗后eCBT-I组与对照组的ISI分值、睡眠潜伏期(SOL)、睡眠效率(SE)均有改善,eCBT-I组ISI减分率、SOL减分率、SE改善率较对照组更明显,差异有统计学意义(P<0.05)。以ISI<8为失眠疗愈指标,eCBT-I组疗愈率高于对照组(37.5%比9.1%,P<0.01)。结论在线失眠认知行为治疗对于慢性失眠患者睡眠状况有一定改善作用。

Objective To explore the effect of online cognitive behavioral therapy(eCBT-I)on chronic insomnia.Methods Seventy eight patients with chronic insomnia were randomly divided into eCBT-I group(n=39)and control group(n=39).The eCBT-I group was given 4-week eCBT-I course,while the control group was only provided with sleep hygiene education.In the fourth week,the sleep diary of one week was recorded again and the insomnia severity index(ISI)was evaluated.The ISI and sleep diary indexes of the treatment group and the control group were compared before and after the first and fourth week,and the curative effect was evaluated with ISI<8 as the recovery index of insomnia.Results Twenty Four patients in the eCBT-I group completed 4 weeks of treatment,and 22 patients in the control group completed 2 times of evaluation.After 4 weeks of treatment,the ISI score,sleep latency(SOL)and sleep efficiency(SE)of the eCBT-I group and the control group were improved.The ISI score reduction rate,SOL score reduction rate and SE improvement rate of the eCBT-I group were more obvious than those of the control group,and the difference was statistically significant(P<0.05).Taking ISI<8 as the index of insomnia recovery,the treatment rate of the eCBT-I group was higher than that of the control group(37.5%vs.9.1%,P<0.01).Conclusions Online cognitive behavioral therapy for insomnia can improve the sleep status of patients with chronic insomnia.