The Efficacy of Cognitive Behavioral Therapy for Insomnia and Factors Associated with Favorable Outcome

Ji-Hyun Jung, B. Lee, H. Moon, Y. Cho
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Abstract

Objectives: Cognitive behavioral therapy for insomnia (CBT-I) is a treatment for chronic insomnia via psychological intervention. CBT-I is as effective as pharmacotherapy for insomnia patients. This study inves tigates the clinical efficacy of CBT-I and factors associated with good outcome. Methods: 27 patients were included in this study, who visited sleep center from October 2011 to June 2012. All patients underwent baseline polysomnography for diagnosis and completed at least three sessions of CBT-I. The sleep scales and sleep diary were done. The clinical efficacy of CBT-I were evaluated by comparing changes of sleep efficacy (SE) between before and after the treatment based on the sleep diary. We grouped these patients into higher SE group and lower SE group according to their final SE. Then we retrospectively reviewed clinical characteristics and polysomnographic parameters in both groups to elucidate the factors associated with favorable outcome of CBT-I. Results: After CBT-I all patients showed significant improvement of sleep parameters (total sleep time, 181 min vs. 308 min; SE, 40% vs. 74%; sleep latency, 100 min vs. 41 min, wakefulness after sleep onset, 185 min vs. 59 min). There were no differences in sleep scales except Beck Depression Inventory between the higher SE group and the lower SE group. There were no differences in subjective sleep parameters of sleep diary between two groups at baseline. Conclusions: At least three sessions of CBT-I at this center was effective. CBT-I was more effective in patients who were depressive. J Korean Sleep Res Soc 2013;10:39-44
认知行为疗法治疗失眠症的疗效及影响预后的因素
目的:认知行为疗法(CBT-I)是一种通过心理干预治疗慢性失眠症的方法。CBT-I治疗失眠症与药物治疗一样有效。本研究探讨CBT-I的临床疗效及影响预后的相关因素。方法:选取2011年10月至2012年6月在睡眠中心就诊的患者27例。所有患者均接受基线多导睡眠图诊断,并完成至少三次CBT-I。完成了睡眠量表和睡眠日记。以睡眠日记为基础,通过比较治疗前后睡眠功效(SE)的变化来评价CBT-I的临床疗效。根据最终SE分为高SE组和低SE组。然后我们回顾了两组患者的临床特征和多导睡眠图参数,以阐明CBT-I治疗效果良好的相关因素。结果:CBT-I后,所有患者的睡眠参数均有显著改善(总睡眠时间,181 min vs 308 min;SE, 40% vs. 74%;睡眠潜伏期,100分钟对41分钟,睡眠开始后觉醒,185分钟对59分钟)。除贝克抑郁量表外,高SE组与低SE组的睡眠量表均无差异。两组在基线时睡眠日记主观睡眠参数无差异。结论:该中心至少三次CBT-I治疗是有效的。CBT-I对抑郁症患者更有效。[J]睡眠研究,2013;10:39-44
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