치료세션을 마치지 않은 환자들에서 불면증인지행동치료의 효과
Clinical Efficacy of Incomplete Cognitive Behavior Therapy for Insomnia
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참고문헌
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초록
Background: It is widely accepted that cognitive-behavioral therapy for insomnia (CBT-I) is more effective thanpharmacological treatments. However, the lack of trained experts and the duration, intensity, and cost of four individualtreatment sessions curtail the widespread use of CBT-I in Korea. The aim of this study was to determine the clinicalefficacy in patients who completed four sessions of CBT-I and in those who did not. Methods: We investigated 81 patients with chronic insomnia (32-82 years old) who participated individual, four-sessionCBT-I between February 2010 and June 2013. The clinical efficacy was evaluated by estimating of total sleep time (TST),sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) based on the sleep diaries. Results: Of the 81 patients, 28 (34.6%) completed the four sessions. 22 (27.1%) withdrew after 1stsession, 17 (20.9%)dropped after 2ndsession, and 8 (9.9%) stopped voluntarily after 3rdsession. Six were excluded due to incomplete sleepdiaries. Clinical efficacy was measured in patients who completed at least two sessions (n=53, 65.4%); the mean SEimproved from 68.8 to 87.6%, and in 40 (75.4%) the SE was normalized (≥85%). Other parameters (TST, from 321.0 to 351.3min; SL, from 61.9 to 25.0 min; WASO, from 86.3 to 24.4 min) were all improved after incomplete CBT-I. Conclusions: Sleep induction and maintenance as well as quality have improved in patients who underwent at least twoof the four CBT-I sessions. It needs to develop briefer CBT-I to increase adherence to patients.
Abstract
Background: It is widely accepted that cognitive-behavioral therapy for insomnia (CBT-I) is more effective thanpharmacological treatments. However, the lack of trained experts and the duration, intensity, and cost of four individualtreatment sessions curtail the widespread use of CBT-I in Korea. The aim of this study was to determine the clinicalefficacy in patients who completed four sessions of CBT-I and in those who did not. Methods: We investigated 81 patients with chronic insomnia (32-82 years old) who participated individual, four-sessionCBT-I between February 2010 and June 2013. The clinical efficacy was evaluated by estimating of total sleep time (TST),sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) based on the sleep diaries. Results: Of the 81 patients, 28 (34.6%) completed the four sessions. 22 (27.1%) withdrew after 1stsession, 17 (20.9%)dropped after 2ndsession, and 8 (9.9%) stopped voluntarily after 3rdsession. Six were excluded due to incomplete sleepdiaries. Clinical efficacy was measured in patients who completed at least two sessions (n=53, 65.4%); the mean SEimproved from 68.8 to 87.6%, and in 40 (75.4%) the SE was normalized (≥85%). Other parameters (TST, from 321.0 to 351.3min; SL, from 61.9 to 25.0 min; WASO, from 86.3 to 24.4 min) were all improved after incomplete CBT-I. Conclusions: Sleep induction and maintenance as well as quality have improved in patients who underwent at least twoof the four CBT-I sessions. It needs to develop briefer CBT-I to increase adherence to patients.
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