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IF 16.3 1区医学 Q1 PSYCHIATRY

Psychotherapy and Psychosomatics Pub Date : 2025-03-21 DOI:10.1159/000545138

Mathilde I Looman, Tessa F Blanken, Tim M Schoenmakers, Joyce E Reesen, Marieke Effting, Floris E Linnebank, Annemieke van Straten, Jan H Kamphuis, Jaap Lancee

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引用次数: 0

摘要

简介：失眠是一种常见病，但其一线治疗方法--失眠认知行为疗法（CBT-I）却很有限。为了探索一种可扩展的替代方法，我们研究了通过电话提供的睡眠限制疗法（SRT）的疗效，该疗法是 CBT-I 的核心组成部分：在一项随机对照试验中，147 名成人失眠患者被分配到为期 6 周的电话指导 SRT 组（76 人）或睡眠日记对照组（71 人）。SRT组每周接受10至15分钟的电话支持。在基线和测试后，我们测量了失眠严重程度（主要结果）、睡眠日记测量、焦虑症状、抑郁症状、睡前唤醒、睡眠安全行为、白天嗜睡以及与睡眠相关的功能障碍认知（次要结果）。SRT组在3个月和6个月的随访中重复这些测量：与睡眠日记对照组相比，电话指导的 SRT 在测试后对失眠严重程度的组间影响较大（d = 1.52；p < .001）。根据意向治疗，36 名（47%）随机接受 SRT 治疗的参与者临床症状得到改善，23 名（30%）失眠症状得到缓解。我们发现，除白天嗜睡和总睡眠时间外，所有次要结果在测试后均有中等至较大的组间效应（d = 0.53 至 1.18）。在 3 个月和 6 个月的随访中，SRT 组的主要结果和所有次要结果，包括白天嗜睡和总睡眠时间，都比基线有所改善（d = 0.50 至 1.93）：这项试验表明，电话指导下的 SRT 是一种有效的失眠治疗方法，只需治疗师提供最低限度的指导。如果与 CBT-I 的直接比较证实了这些发现，SRT 可能会成为 CBT-I 的一种有趣的可扩展替代疗法，作为一线失眠治疗方法：NCT05548907.

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Telephone-guided sleep restriction for insomnia: A randomized sleep diary-controlled trial.

Introduction: Insomnia is common, but access to its first-line treatment, Cognitive Behavioral Therapy for Insomnia (CBT-I), is limited. To explore a scalable alternative, we investigated the efficacy of Sleep Restriction Therapy (SRT), a core component of CBT-I, delivered via telephone.

Methods: In a randomized controlled trial, 147 adults with insomnia were allocated to 6 weeks of telephone-guided SRT (n = 76) or a sleep diary control group (n = 71). The SRT group received weekly supporting phone calls lasting 10 to 15 minutes. At baseline and post-test, we measured insomnia severity (primary outcome), sleep diary measures, anxiety symptoms, depressive symptoms, pre-sleep arousal, sleep-safety behaviors, daytime sleepiness, and dysfunctional sleep-related cognitions (secondary outcomes). The SRT group repeated these measures at 3- and 6-month follow-up.

Results: Telephone-guided SRT showed large between-group effects on insomnia severity at post-test relative to the sleep diary control group (d = 1.52; p < .001). Based on intention-to-treat, 36 (47%) participants randomized to SRT achieved clinical improvement, and 23 (30%) achieved insomnia remission. We found medium-to-large between-group effects at post-test (d = 0.53 to 1.18) for all secondary outcomes except daytime sleepiness and total sleep time. At 3- and 6-month follow-up, the primary and all secondary outcomes, including daytime sleepiness and total sleep time, improved relative to baseline within the SRT group (d = 0.50 to 1.93).

Conclusion: This trial shows that telephone-guided SRT is an effective insomnia treatment requiring minimal therapist guidance. If direct comparisons with CBT-I corroborate these findings, SRT could be an interesting scalable alternative to CBT-I as a first-line insomnia treatment.

Trial registry: NCT05548907.

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来源期刊

Psychotherapy and Psychosomatics 医学-精神病学

CiteScore

29.40

自引率

6.10%

发文量

期刊介绍： Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.