OBJECTIVE:Insomnia is a major health problem, and the need for effective and accessible treatment is urgent. The aim of the current study was to evaluate the short-term efficacy of an unguided Internet-based cognitive-behavioral treatment program for insomnia (CBTi), called SHUTi (Sleep Healthy Using the Internet). METHODS:This study used a parallel arm randomized controlled trial in Norway. Participants were randomly allocated to the SHUTi condition or a Web-based patient education condition. Both groups were assessed before and after the nine-week intervention period (online sleep diaries and questionnaires). The SHUTi participants were reassessed in a six-month nonrandomized follow-up. Primary outcome measures were the Insomnia Severity Index (ISI) and the Bergen Insomnia Scale (BIS). RESULTS:A total of 181 participants were included in the study; SHUTi condition (n = 95), patient education condition (n = 86). Intention-to-treat mixed-model repeated-measures analysis revealed that the SHUTi group had better short-term outcomes compared with the patient education group on most sleep measures. The SHUTi group showed a significant decrease on the primary outcomes, the ISI (dbetween = -1.77, 95% CI = -2.23, -1.31) and the BIS (dbetween = -1.00, 95% CI = -1.32, -.68). Improvements were maintained among the completing SHUTi participants at the six-month nonrandomized follow-up. However, dropout attrition was high. CONCLUSION:Unguided Internet-based CBTi produced significant short-term improvements in sleep in patients with chronic insomnia. This highlights the benefits of making Internet-delivered CBTi programs available as a standard first-line treatment option in public health services. Nevertheless, the rate of dropout attrition (participants not completing post-assessment) in this trial limits the generalizability of the findings.

译文

目的:失眠是一个主要的健康问题,迫切需要有效和容易获得的治疗。本研究的目的是评估一种名为SHUTi(使用互联网睡眠健康)的基于互联网的无指导性失眠认知行为治疗计划(CBTi)的短期疗效。
方法:本研究在挪威进行了一项平行臂随机对照试验。参与者被随机分配到SHUTi状况或基于Web的患者教育状况。在九周的干预期前后(在线睡眠日记和问卷)对两组进行了评估。在为期六个月的非随机随访中,对SHUTi参与者进行了重新评估。主要结局指标为失眠严重程度指数(ISI)和卑尔根失眠量表(BIS)。
结果:总共181名参与者被纳入研究。 SHUTi病状(n = 95),患者教育病状(n = 86)。意向治疗混合模型重复测量分析显示,与大多数患者的睡眠测量教育组相比,SHUTi组的短期预后要好。 SHUTi组显示主要结局,ISI(介于-1.77、95%CI = -2.23,-1.31)和BIS(介于-1.00、95%CI = -1.32,-。68之间)显着降低。 。在为期六个月的非随机随访中,完成的SHUTi参与者保持了改善。但是,辍学率高。
结论:基于互联网的无指导的CBTi在慢性失眠患者的睡眠中产生了显着的短期改善。这凸显了将Internet提供的CBTi程序作为公共卫生服务中的标准一线治疗选项提供的好处。但是,该试验中的辍学率(参加者未完成评估后)的流失率限制了研究结果的普遍性。

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