{"title":"最小认知行为疗法对急性失眠患者的影响：系统回顾与荟萃分析","authors":"","doi":"10.1016/j.sleep.2024.08.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>The current literature lacks a clear evaluation of the effectiveness of Cognitive Behavioral Therapy for Insomnia (CBT-I) on acute insomnia. Our study aims to address this issue through a systematic review and meta-analysis of Randomized Controlled Trials (RCTs).</p></div><div><h3>Method</h3><p>We systematically searched PubMed, Embase, and Cochrane Library in April 2024 for RCTs comparing patients with clinically significant insomnia symptoms for less than 6 months (ie, acute insomnia) assigned to 1–6 weeks of CBT-I versus no CBT-I.</p></div><div><h3>Results</h3><p>We included four RCTs comprising 327 patients with acute insomnia, of whom 162 (49.5 %) were randomized to CBT-I. CBT-I significantly reduced the Insomnia Severity Index score (MD –5.28; 95 % CI −6.01, −4.56; p < 0.00001; I<sup>2</sup> = 18 %), the incidence of chronic insomnia (MD 0.50; 95 % CI 0.35, 0.70; p < 0.0001; I<sup>2</sup> = 0 %), and the sleep latency (MD -11.04; 95 % CI –18.46, −3.61; p = 0.004; I<sup>2</sup> = 0 %).</p></div><div><h3>Conclusion</h3><p>These findings provide preliminary evidence that minimal CBT-I may be a feasible and effective preventive measure against chronic insomnia. However, future RCTs and effectiveness trials are necessary to validate, with greater statistical power, the hypothesis that CBT-I can prevent transition from acute to chronic insomnia, given the limited number of studies in our meta-analysis.</p></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of minimal cognitive behavioral therapy for patients with acute insomnia: A systematic review and meta-analysis\",\"authors\":\"\",\"doi\":\"10.1016/j.sleep.2024.08.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>The current literature lacks a clear evaluation of the effectiveness of Cognitive Behavioral Therapy for Insomnia (CBT-I) on acute insomnia. Our study aims to address this issue through a systematic review and meta-analysis of Randomized Controlled Trials (RCTs).</p></div><div><h3>Method</h3><p>We systematically searched PubMed, Embase, and Cochrane Library in April 2024 for RCTs comparing patients with clinically significant insomnia symptoms for less than 6 months (ie, acute insomnia) assigned to 1–6 weeks of CBT-I versus no CBT-I.</p></div><div><h3>Results</h3><p>We included four RCTs comprising 327 patients with acute insomnia, of whom 162 (49.5 %) were randomized to CBT-I. CBT-I significantly reduced the Insomnia Severity Index score (MD –5.28; 95 % CI −6.01, −4.56; p < 0.00001; I<sup>2</sup> = 18 %), the incidence of chronic insomnia (MD 0.50; 95 % CI 0.35, 0.70; p < 0.0001; I<sup>2</sup> = 0 %), and the sleep latency (MD -11.04; 95 % CI –18.46, −3.61; p = 0.004; I<sup>2</sup> = 0 %).</p></div><div><h3>Conclusion</h3><p>These findings provide preliminary evidence that minimal CBT-I may be a feasible and effective preventive measure against chronic insomnia. However, future RCTs and effectiveness trials are necessary to validate, with greater statistical power, the hypothesis that CBT-I can prevent transition from acute to chronic insomnia, given the limited number of studies in our meta-analysis.</p></div>\",\"PeriodicalId\":21874,\"journal\":{\"name\":\"Sleep medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-08-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sleep medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1389945724003587\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sleep medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1389945724003587","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的目前的文献缺乏对失眠认知行为疗法（CBT-I）对急性失眠症疗效的明确评估。我们的研究旨在通过对随机对照试验（RCTs）进行系统回顾和荟萃分析来解决这一问题。方法我们在 2024 年 4 月系统地检索了 PubMed、Embase 和 Cochrane 图书馆的 RCTs，比较了临床症状明显的失眠患者接受 1-6 周 CBT-I 与未接受 CBT-I 治疗的情况。CBT-I 可明显降低失眠严重程度指数得分（MD -5.28; 95 % CI -6.01, -4.56; p < 0.00001; I2 = 18 %）、慢性失眠发生率（MD 0.50; 95 % CI 0.35, 0.70; p < 0.0001; I2 = 0 %）和睡眠潜伏期（MD -11.04; 95 % CI -18.46, -3.61; p = 0.004; I2 = 0 %）。然而，鉴于我们的荟萃分析中的研究数量有限，未来有必要进行研究性临床试验和有效性试验，以更大的统计能力验证 CBT-I 可以预防急性失眠向慢性失眠转变的假设。
Effect of minimal cognitive behavioral therapy for patients with acute insomnia: A systematic review and meta-analysis
Objectives
The current literature lacks a clear evaluation of the effectiveness of Cognitive Behavioral Therapy for Insomnia (CBT-I) on acute insomnia. Our study aims to address this issue through a systematic review and meta-analysis of Randomized Controlled Trials (RCTs).
Method
We systematically searched PubMed, Embase, and Cochrane Library in April 2024 for RCTs comparing patients with clinically significant insomnia symptoms for less than 6 months (ie, acute insomnia) assigned to 1–6 weeks of CBT-I versus no CBT-I.
Results
We included four RCTs comprising 327 patients with acute insomnia, of whom 162 (49.5 %) were randomized to CBT-I. CBT-I significantly reduced the Insomnia Severity Index score (MD –5.28; 95 % CI −6.01, −4.56; p < 0.00001; I2 = 18 %), the incidence of chronic insomnia (MD 0.50; 95 % CI 0.35, 0.70; p < 0.0001; I2 = 0 %), and the sleep latency (MD -11.04; 95 % CI –18.46, −3.61; p = 0.004; I2 = 0 %).
Conclusion
These findings provide preliminary evidence that minimal CBT-I may be a feasible and effective preventive measure against chronic insomnia. However, future RCTs and effectiveness trials are necessary to validate, with greater statistical power, the hypothesis that CBT-I can prevent transition from acute to chronic insomnia, given the limited number of studies in our meta-analysis.
期刊介绍：
Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without.
A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry.
The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.
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