失眠认知行为治疗对抑郁症伴失眠患者的治疗效果

Effect of Cognitive Behavioral Therapy for Insomnia on Patients with Depression and Insomnia

目的:探讨失眠的认知行为治疗(CBT-I)对抑郁症伴失眠患者睡眠进程及睡眠结构的影响。方法:选择2011年10月-2020年12月东莞市第七人民医院收治的82例抑郁症伴失眠患者作为研究对象,分为观察组42例和对照组40例。对照组予以药物治疗,观察组除药物治疗外同时进行失眠的认知行为治疗。比较两组治疗前后匹兹堡睡眠质量指数(PSQI)评分、汉密尔顿焦虑量表(HAMA)评分、睡眠进程指标觉醒次数(AT)、实际睡眠总时间(TST)、睡眠效率(SE)、睡眠潜伏期(SL)、潜伏期(RL)、睡眠结构指标睡眠阶段1(S1)、2(S2)、3(S3)及快速眼球运动睡眠(REM)占睡眠百分比。结果:治疗6周后,观察组PSQI、HAMA评分均低于对照组,差异有统计学意义(P<0.05)。治疗6周后,观察组AT、SL、RL指标均低于对照组,TST、SE高于对照组,差异有统计学意义(P<0.05)。治疗6周后,观察组S2占睡眠百分比低于对照组,同时观察组S3、REM占睡眠百分比高于对照组,差异有统计学意义(P<0.05)。结论:失眠的CBT-I能够改善抑郁症伴失眠患者的睡眠进程及睡眠结构,提高生活质量。

Objective:To explore the effect of cognitive behavioral therapy for insomnia(CBT-I)on sleep process and sleep structure of depression and insomnia patients.Methods:Eighty-two patients with depression and insomnia who were admitted in Dongguan Seventh People's Hospital from October 2018 to December 2020 were selected and divided into the observation group(n=42)and the control group(n=40).The control group received drug treatment,while the observation group received CBT-I in addition to drug treatment.Pittsburgh sleep quality index(PSQI)score,Hamilton Anxiety Scale(HAMA)score,sleep process index arousal times(AT),total sleep time(TST),sleep efficiency(SE),and sleep latency(SL),latency(RL),sleep structure indicators sleep stages 1(S1),2(S2),3(S3)and rapid eye movement(REM)accounted for sleep were compared between the two groups before and after treatment.Results:After 6 weeks of treatment,the PSQI and HAMA scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).After 6 weeks of treatment,the indexes of AT,SL and RL in the observation group were lower than those in the control group,while the TST and SE in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After 6 weeks of treatment,the percentage of S2 in sleep in the observation group was lower than that in the control group,while the percentage of S3 and REM in sleep in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion:CBT-I can better improve the sleep process and sleep structure of patients with depression and insomnia,and can improve the qualith of life.