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The Lancet Digital Health:失眠新疗法可有效改善睡眠状况,降低睡眠药物依赖

2020-08-07 探索菌 生物探索

一个奇怪的现象是,随着社会不断发展,睡不好、睡不着的人反而越来越多了。据统计,全球约有27%正在遭受失眠的折磨,而在中国,近3亿人存在睡眠障碍,并且每10位失眠人士中就有8人年龄在35岁以下。

一个奇怪的现象是,随着社会不断发展,睡不好、睡不着的人反而越来越多了。据统计,全球约有27%正在遭受失眠的折磨,而在中国,近3亿人存在睡眠障碍,并且每10位失眠人士中就有8人年龄在35岁以下。

由于该疾病的认识不足,我国仅有不到40%的患者寻求医疗救助,并且治疗方法仍然沿袭传统上的的药物治疗,国际上主流的认知行为疗法(CBT-1,通过交谈帮助患者理清问题所在)因成本过高、专业医师不足,无法得到普及。

最近,《柳叶刀-数字健康》发布的一篇研究报告为广大失眠人士改善睡眠状况指明了方向。挪威科技大学的一支研究团队首次发现,线上进行的数字化认知行为疗法(dCBT-1)不仅能够有效减轻失眠症相关症状的严重程度,而且有助于降低患者对睡眠药物的依赖性,改善患者身心健康。

此前已有研究表明,dCBT-1有助于改善人们的睡眠状况、降低抑郁症状,不过这些研究缺乏能够证明该疗法在不同年龄段的人群中普遍有效的证据,并且没有将dCBT-1与其他睡眠疗法进行对比。

为了弥补了这些缺陷,研究人员在挪威进行了一项随机平行对照试验(RCT),将dCBT-I与关于睡眠的在线患者教育的治疗效果进行了对比。

2016年2月26日至2018年7月1日期间,研究人员建立了一个专门用来进行这项实验的网站,通过全自动程序筛选受试者并针对目标群体开展在线干预措施。具体而言,筛选条件包括失眠严重度指数(ISI)在12分以上、无潜在健康状况且能保证完成测试等等。

最终,有1721名参与者被随机分配到dCBT-1组(868人)和患者教育组(853人),他们的平均年龄为45岁(区间为18-90),近70%(1167人)的参与者为女性,62%(1074人)已婚或同居。在有可用数据的1701名参与者中,66%(1123人)自我报告了6年或更长时间的睡眠问题。治疗时间为9周,期间参与者被要求每天完成有关睡眠质量及改善情况的问卷。

对信息进行了分析后,研究人员发现dCBT-1的疗效更为显着。从ISI评分来看,dCBT-1组得分从最初的19.2降到了10.4,相当于从中度失眠转变为“亚临床失眠”;患者教育组得分从19.6降至15.2,仍处于中度失眠状态。同时,接受治疗后,dCBT-1组有38%符合失眠缓解标准,而患者教育组中仅有8%符合条件,二者相差近5倍。

另外,dCBT-1疗法帮助参与者在更多方面获得了改善。治疗期间,与患者教育组相比,dCBT-1组参与者失眠药物的使用率要低49%,疲劳程度要少40%。

这是第一个大规模、全自动dCBT-I试验,证明了该疗法能够有效减少与失眠症相关的夜间和白天障碍,并降低人们对睡眠药物的使用和依赖性。通过改变行为,这种有效、廉价的疗法将有助于更多失眠患者重新感受夜晚的美好。

原始出处:
Oystein Vedaa,H?vard Kallestad,Prof Jan Scott,et al.Effects of digital cognitive behavioural therapy for insomnia on insomnia severity: a large-scale randomised controlled trial.The Lancet Digital Health.VOLUME 2, ISSUE 8, E397-E406, AUGUST 01, 2020.August, 2020DOI:https://doi.org/10.1016/S2589-7500(20)30135-7

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    2021-12-23 ms8000001104763615

    12

    0

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    2020-08-16 shizhenshan
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    2020-08-25 howi
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    2021-07-21 venlin
  5. [GetPortalCommentsPageByObjectIdResponse(id=1083453, encodeId=650610834531c, content=12, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=17785603162, createdName=ms8000001104763615, createdTime=Thu Dec 23 08:57:31 CST 2021, time=2021-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861395, encodeId=5f2e186139582, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Sun Aug 16 18:42:52 CST 2020, time=2020-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830773, encodeId=e4b31830e7325, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Aug 25 13:42:52 CST 2020, time=2020-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784334, encodeId=517b1e8433413, content=<a href='/topic/show?id=98275961cd' target=_blank style='color:#2F92EE;'>#digital#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5961, encryptionId=98275961cd, topicName=digital)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aae2431, createdName=venlin, createdTime=Wed Jul 21 00:42:52 CST 2021, time=2021-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813742, encodeId=16ef813e421c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Thu Aug 27 08:06:15 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554586, encodeId=340b155458615, content=<a href='/topic/show?id=74e458559f5' target=_blank style='color:#2F92EE;'>#新疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58559, encryptionId=74e458559f5, topicName=新疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d03114536414, createdName=kcb074, createdTime=Sun Aug 09 02:42:52 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621864, encodeId=22301621864cc, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Sun Aug 09 02:42:52 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033917, encodeId=8acf103391eea, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Fri Aug 07 14:42:52 CST 2020, time=2020-08-07, status=1, ipAttribution=)]
    2020-08-27 14818eb4m67暂无昵称

    学习了

    0

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    2020-08-09 kcb074
  7. [GetPortalCommentsPageByObjectIdResponse(id=1083453, encodeId=650610834531c, content=12, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=17785603162, createdName=ms8000001104763615, createdTime=Thu Dec 23 08:57:31 CST 2021, time=2021-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861395, encodeId=5f2e186139582, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Sun Aug 16 18:42:52 CST 2020, time=2020-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830773, encodeId=e4b31830e7325, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Aug 25 13:42:52 CST 2020, time=2020-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784334, encodeId=517b1e8433413, content=<a href='/topic/show?id=98275961cd' target=_blank style='color:#2F92EE;'>#digital#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5961, encryptionId=98275961cd, topicName=digital)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aae2431, createdName=venlin, createdTime=Wed Jul 21 00:42:52 CST 2021, time=2021-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813742, encodeId=16ef813e421c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Thu Aug 27 08:06:15 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554586, encodeId=340b155458615, content=<a href='/topic/show?id=74e458559f5' target=_blank style='color:#2F92EE;'>#新疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58559, encryptionId=74e458559f5, topicName=新疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d03114536414, createdName=kcb074, createdTime=Sun Aug 09 02:42:52 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621864, encodeId=22301621864cc, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Sun Aug 09 02:42:52 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033917, encodeId=8acf103391eea, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Fri Aug 07 14:42:52 CST 2020, time=2020-08-07, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1083453, encodeId=650610834531c, content=12, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=17785603162, createdName=ms8000001104763615, createdTime=Thu Dec 23 08:57:31 CST 2021, time=2021-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861395, encodeId=5f2e186139582, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Sun Aug 16 18:42:52 CST 2020, time=2020-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830773, encodeId=e4b31830e7325, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Tue Aug 25 13:42:52 CST 2020, time=2020-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784334, encodeId=517b1e8433413, content=<a href='/topic/show?id=98275961cd' target=_blank style='color:#2F92EE;'>#digital#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5961, encryptionId=98275961cd, topicName=digital)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aae2431, createdName=venlin, createdTime=Wed Jul 21 00:42:52 CST 2021, time=2021-07-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813742, encodeId=16ef813e421c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Thu Aug 27 08:06:15 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554586, encodeId=340b155458615, content=<a href='/topic/show?id=74e458559f5' target=_blank style='color:#2F92EE;'>#新疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58559, encryptionId=74e458559f5, topicName=新疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d03114536414, createdName=kcb074, createdTime=Sun Aug 09 02:42:52 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621864, encodeId=22301621864cc, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Sun Aug 09 02:42:52 CST 2020, time=2020-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033917, encodeId=8acf103391eea, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Fri Aug 07 14:42:52 CST 2020, time=2020-08-07, status=1, ipAttribution=)]
    2020-08-07 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

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失眠在稳定型心力衰竭(HF)患者中很常见,并与炎症和自主神经功能改变有关。本研究旨在探究认知行为疗法治疗失眠(CBT-I)对下丘脑垂体(HPA)轴、自主神经功能、炎症和昼夜节律性的影响,以及这些生物标

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