Who to Refer to a Behavioral Insomnia Clinic? - Recommendations Based on Treatment Rationale and Response Prediction.

IF 1.5 Q4 CLINICAL NEUROLOGY

Current Sleep Medicine Reports Pub Date : 2021-01-01 Epub Date: 2021-11-17 DOI:10.1007/s40675-021-00220-3

Joshua H Cho, Stephanie Kremer, Jeffrey Young

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引用次数: 4

Abstract

Purpose of review: Response to cognitive-behavioral therapy for insomnia (CBT-I) is variable across individuals, and specialty insomnia clinics that provide CBT-I are few. To personalize insomnia treatments and maximize the cost-effectiveness of CBT-I, this paper reviews the conceptual model and content of CBT-I and the predictors of adherence/response to CBT-I as the basis for understanding who is most likely to benefit from CBT-I.

Recent findings: Specific patient-related attributes that predict benefit from CBT-I include (1) presence of maladaptive behaviors that serve as perpetuating factors of insomnia; (2) greater motivation to pursue therapy and higher treatment expectancies regarding CBT-I; (3) reduced use of hypnotics; (4) longer sleep duration; and (5) adequately treated psychiatric comorbidities.

Summary: People presenting with chronic insomnia and these attributes may warrant prioritization in referral to behavioral insomnia clinics. Conversely, those who do not have such favorable characteristics may require interventions that address modifiable factors associated with poor adherence/response to CBT-I.

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向谁咨询行为失眠症诊所?-基于治疗原理和反应预测的建议。

综述目的:个体对认知行为治疗失眠(CBT-I)的反应是不同的，提供CBT-I的专业失眠诊所很少。为了使失眠治疗个性化，使CBT-I的成本效益最大化，本文回顾了CBT-I的概念模型和内容，以及对CBT-I的依从性/反应的预测因素，作为了解谁最有可能从CBT-I中受益的基础。最近的发现:预测CBT-I获益的特定患者相关属性包括:(1)作为失眠持续因素的适应不良行为的存在;(2)对CBT-I有更大的治疗动机和更高的治疗期望;(3)催眠药使用减少;(4)睡眠时间较长;(5)充分治疗精神合并症。总结:表现为慢性失眠症和这些特征的人可能需要优先转诊到行为失眠症诊所。相反，那些没有这些有利特征的人可能需要干预，以解决与CBT-I依从性差/反应不良相关的可改变因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Sleep Medicine Reports Medicine-Pulmonary and Respiratory Medicine

CiteScore

2.50

自引率

5.60%

发文量

期刊介绍： Current Sleep Medicine Reports aims to review the most important, recently published articles in the field of sleep medicine. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of sleep conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas such as insomnia, narcolepsy, sleep apnea, circadian rhythm disorders, and parasomnias. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also occasionally provided.