失眠的在线简版行为疗法对失眠障碍的干预效果研究
The Effect of E-aid Brief Behavioral Therapy for Insomnia on Insomnia Disorders
陈鹏飞 1刘雅茜 2王途之 2张桂梅 2蔡艺娴 2潘集阳2
作者信息
- 1. 510630 广东省广州市,暨南大学附属第一医院睡眠医学中心;510630 广东省广州市,暨南大学管理学院
- 2. 510630 广东省广州市,暨南大学附属第一医院睡眠医学中心
- 折叠
摘要
背景 失眠障碍是一种常见的精神疾病,给患者的生活和健康带来严重的负面影响.传统的认知行为疗法(CBT-I)是一种有效的非药物治疗方法,但其操作复杂、耗时长、依从性低等缺点限制了其在真实世界的应用.简版行为疗法(BBT-I)是一种基于CBT-I的简化治疗方法,其疗效与CBT-I相当,更适合在真实世界中推广.然而,BBT-I是否适用于中国失眠障碍人群暂不明确,而通过线上方式进行BBT-I的研究更是缺乏.目的 本研究旨在探讨通过微信小程序进行的在线BBT-I(eBBT-I)对中国失眠障碍患者失眠改善的疗效,以及其对患者睡眠信念和态度的影响.方法 本研究采用前瞻性非随机对照研究的设计,将 2023 年 2-11 月来自暨南大学附属第一医院精神医学科睡眠门诊的失眠障碍患者设为干预组,将线上和线下招募的失眠障碍志愿者设为对照组,干预组接受为期 2 周的eBBT-I治疗,对照组接受精神卫生教育的伪干预.在干预前后分别测量患者的失眠严重程度指数量表(ISI)和简版睡眠信念与态度问卷(DBAS-16)得分,以评估干预效果.结果 研究最终共纳入35例干预组患者和30例对照组患者.主要结局指标:组别与时间对ISI得分存在交互作用(P＜0.05);组别与时间分别对ISI得分主效应显著(P＜0.05).干预前3 d(基线)两组ISI得分比较,差异无统计学意义(P＞0.05);干预后14 d干预组ISI得分低于对照组(P＜0.05);干预组干预后 14 d ISI得分低于组内干预前(P＜0.05).次要结局指标:组别与时间对DBAS-16 得分不存在交互作用(P＞0.05);时间对DBAS-16 得分主效应显著(P＜0.05);组别对DBAS-16 得分主效应不显著(P＞0.05).干预前3 d(基线)、干预后 14 d两组DBAS-16 得分比较,差异无统计学意义(P＞0.05);干预组干预后 14 d DBAS-16 得分高于组内干预前(P＜0.05).结论 eBBT-I有效地改善了失眠障碍患者的失眠症状和负面影响,但对睡眠信念与态度的改善效果仍有待提升.本研究支持了eBBT-I在中国失眠障碍患者失眠治疗中的可行性和有效性.
Abstract
Background Insomnia disorder is a common mental health condition that significantly impacts patients'lives and well-being.Traditional cognitive-behavioral therapy for insomnia(CBT-I)is an effective non-pharmacological treatment method,but its complexity,time-consuming nature,and low compliance limit its real-world application.Brief behavioral therapy for insomnia(BBT-I),based on CBT-I principles,offers comparable efficacy while being more suitable for real-world dissemination.However,the applicability of BBT-I to the Chinese population with insomnia disorder remains unclear,and research on BBT-I conducted online is lacking.Objective This study aims to investigate the efficacy of online e-aid brief behavioral therapy for insomnia(eBBT-I)delivered via WeChat Mini Program in improving insomnia symptoms among Chinese patients with insomnia disorder.Additionally,the study explores its impact on patients'sleep beliefs and attitudes.Methods This study employed a prospective non-randomized controlled design.Insomnia disorder patients from the Sleep Clinic at the First Affiliated Hospital of Jinan University between February and November 2023 were assigned to the intervention group.Insomnia disorder volunteers recruited online and offline were assigned to the control group.The intervention group received a 2-week eBBT-I(e-aid brief behavioral therapy for insomnia)treatment,while the control group received a sham intervention of mental health education.The severity of insomnia was assessed using the Insomnia Severity Index(ISI)and the Dysfunctional Beliefs and Attitudes about Sleep-16(DBAS-16)questionnaire before and after the intervention to evaluate its effectiveness.Results The study ultimately included 35 patients in the intervention group and 30 patients in the control group.Key outcome measures:there was a significant interaction effect between group and time for ISI scores(P＜0.05).Group and time separately had significant main effects on ISI scores(P＜0.05).No statistically significant difference in ISI scores was observed between the two groups at baseline(pre-intervention)(P＞0.05).After 14 days of intervention,the intervention group had lower ISI scores than the control group(P＜0.05).Within the intervention group,ISI scores decreased after 14 days compared to baseline(P＜0.05).Secondary outcome measures:there was no interaction effect between group and time for DBAS-16 scores(P＞0.05).Time had a significant main effect on DBAS-16 scores(P＜0.05).Group did not have a significant main effect on DBAS-16 scores(P＞0.05).No statistically significant difference in DBAS-16 scores was found between the two groups at baseline or after 14 days(P＞0.05).However,within the intervention group,DBAS-16 scores increased after 14 days compared to baseline(P＜0.05).Conclusion This indicates that eBBT-I effectively improved insomnia symptoms and negative impact in patients with insomnia disorder,but further improvement in sleep beliefs and attitudes is still needed.This study supports the feasibility and effectiveness of eBBT-I in the treatment of insomnia disorder among Chinese patients.
关键词
失眠障碍/失眠在线简版行为疗法/失眠的非药物治疗/数智化医疗诊疗工具/失眠严重程度指数/睡眠信念与态度Key words
Insomnia disorder/E-aid brief behavioral therapy for insomnia/Non-drug treatment for insomnia/Digital medical diagnostic and treatment tools/Insomnia Severity Index/Sleep beliefs and attitudes引用本文复制引用
基金项目
国家重点研发计划(2022YFC2503900)
出版年
2024
国家科技期刊平台
NSTL
万方数据