| 贾丽君,何梦婷,何佳蔚,陈晓娅,陈胡丹,王怡,姚静.失眠的认知行为治疗对失眠障碍患者睡眠质量和认知功能的影响[J].四川精神卫生杂志,2023,36(3):248-253.Jia Lijun,He Mengting,He Jiawei,Chen Xiaoya,Chen Hudan,Wang Yi,Yao Jing,Effect of cognitive behavioral therapy for insomnia on sleep quality and cognitive function in patients with chronic insomnia disorder[J].SICHUAN MENTAL HEALTH,2023,36(3):248-253 |
| 失眠的认知行为治疗对失眠障碍患者睡眠质量和认知功能的影响 |
| Effect of cognitive behavioral therapy for insomnia on sleep quality and cognitive function in patients with chronic insomnia disorder |
| 投稿时间：2023-01-05 |
| DOI：10.11886/scjsws20230105002 |
| 中文关键词: 失眠 失眠的认知行为治疗 认知功能 睡眠质量 |
| 英文关键词:Insomnia Cognitive Behavior Therapy for Insomnia Cognitive function Sleep quality |
| 基金项目:四川省卫生健康委员会科研课题（项目名称：认知行为治疗对慢性失眠障碍患者的睡眠质量和认知功能的影响；项目编号：19PJ216） |
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| 中文摘要: |
| 背景 失眠障碍已成为当前社会的一种常见疾病，失眠的认知行为治疗（CBTI）是失眠障碍的非药物治疗方法之一，其对失眠障碍患者睡眠质量和认知功能影响的研究有限。目的 探索CBTI对失眠障碍患者睡眠质量和认知功能的影响，为失眠障碍的非药物治疗提供参考。方法 选取2021年1月-2022年10月在四川省精神卫生中心就诊、符合《精神障碍诊断与统计手册（第5版）》（DSM-5）诊断标准的47例失眠障碍患者为研究对象。患者接受为期6周的CBTI治疗。治疗前，采用汉密尔顿抑郁量表24项（HAMD-24）和汉密尔顿焦虑量表（HAMA）评定患者的抑郁和焦虑症状，在治疗前及治疗6周后采用匹兹堡睡眠质量指数量表（PSQI）和蒙特利尔认知评估量表（MoCA）评定患者的睡眠情况和认知功能。采用Spearman相关分析考查治疗后失眠障碍患者PSQI总评分减分值与MoCA总评分增分值的相关性。结果 治疗6周后，失眠障碍患者PSQI的主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍因子评分及PSQI总评分均低于治疗前，差异均有统计学意义（t=5.569~15.290，P均<0.01），MoCA的视空间与执行功能、命名、注意力、语言能力、抽象思维、记忆力因子评分及总评分均高于治疗前，差异均有统计学意义（t=-11.273~-4.277，P均<0.01）。Spearman相关分析显示，经6周CBTI治疗后，失眠障碍患者PSQI总评分减分值与MoCA总评分增分值呈正相关（r=0.323，P=0.027）。结论 CBTI可能有助于改善失眠障碍患者的睡眠质量和认知功能。CBTI干预后，失眠障碍患者睡眠质量的提高可能与认知功能的改善存在一定的关联。 |
| 英文摘要: |
| Background Insomnia disorder has become a common disease in the current society. Cognitive Behavior Therapy for Insomnia （CBTI） is one of the non-drug treatment methods for insomnia disorder， but relevant studies of its effect on sleep quality and cognitive function of patients with insomnia disorder are limited.Objective To explore the effects of CBTI on sleep quality and cognitive function in patients with insomnia disorder， so as to provide references for non-drug treatment of insomnia disorder.Methods A total of 47 patients with insomnia disorder were recruited as the study subjects. They all met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and have visited Sichuan Mental Health Center from January 2021 to October 2022. The patients underwent CBTI for 6 weeks. Before the treatment， depression and anxiety symptoms were assessed using Hamilton Depression Scale-24 item （HAMD-24） and Hamilton Anxiety Scale （HAMA）. Sleep status and cognitive function were assessed using Pittsburgh Sleep Quality Index （PSQI） and Montreal Cognitive Assessment （MoCA） before and 6 weeks after the treatment. Spearman correlation analysis was used to examine the correlation between the reduction of PSQI score and the increase of MoCA score after treatment.Results After the 6-week treatment， the factor scores and total score of PSQI across 6 subscales （the sleep quality， sleep onset time， sleep time， sleep efficiency， sleep disorder and daytime dysfunction） were lower than those before the treatment， and the score differences were of statistical significance （t=5.569~15.290， P<0.01）. Both factor and total scores of MoCA across 6 items （visuospatial and executive， naming， attention， language， abstraction and memory） were significantly higher than those before the treatment with score differences reaching statistical significance （t=-11.273~-4.277， P<0.01）. Spearman correlation analysis demonstrated that there was a positive correlation between the decrease in PSQI total score and the increase in MoCA total score after the 6-week CBTI treatment （r=0.323， P=0.027）.Conclusion CBTI may help improve sleep quality and cognitive function in patients with insomnia disorders. The improvement of sleep quality after CBTI intervention may be related to the improvement of cognitive function. ［Funded by Scientific Research Project of Sichuan Provincial Health Commission （number， 19PJ216）］ |
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