催眠联合失眠的认知行为治疗对伴有焦虑的慢性失眠患者的疗效观察

韩容; 赵媛; 雷洋梅; 于江游; 蒋成刚

doi:10.16016/j.1000-5404.201809030

您当前的位置：

首页 >

文章列表页 >

催眠联合失眠的认知行为治疗对伴有焦虑的慢性失眠患者的疗效观察

医学心理学 | 更新时间：2026-01-09

- 催眠联合失眠的认知行为治疗对伴有焦虑的慢性失眠患者的疗效观察
- Efficacy of hypnosis combined with cognitive behavior therapy for insomnia for intervention of chronic insomnia with anxiety
- 第三军医大学学报 2019年41卷第4期页码：394-398, 封三
- 作者机构：
  
  400021 重庆，重庆市妇幼保健院心理科
- 作者简介：
  
  [ 蒋成刚，E-mail：jcgaqq@126.com JIANG Chenggang, E-mail: jcgaqq@126.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201809030
  中图分类号： R256.23;R338.63;R395.5
- 收稿：2018-09-05，
  
  修回：2018-10-13，
  
  纸质出版：2019-02-28
- 稿件说明：
移动端阅览
韩容, 赵媛, 雷洋梅, 等. 催眠联合失眠的认知行为治疗对伴有焦虑的慢性失眠患者的疗效观察[J]. 第三军医大学学报, 2019,41(4):394-398, 封三.

Rong HAN, Yuan ZHAO, Yangmei LEI, et al. Efficacy of hypnosis combined with cognitive behavior therapy for insomnia for intervention of chronic insomnia with anxiety[J]. Journal of Third Military Medical University, 2019, 41(4): 394-398, 封三.
韩容, 赵媛, 雷洋梅, 等. 催眠联合失眠的认知行为治疗对伴有焦虑的慢性失眠患者的疗效观察[J]. 第三军医大学学报, 2019,41(4):394-398, 封三. DOI： 10.16016/j.1000-5404.201809030.

Rong HAN, Yuan ZHAO, Yangmei LEI, et al. Efficacy of hypnosis combined with cognitive behavior therapy for insomnia for intervention of chronic insomnia with anxiety[J]. Journal of Third Military Medical University, 2019, 41(4): 394-398, 封三. DOI： 10.16016/j.1000-5404.201809030.

摘要

目的

探讨失眠的认知行为治疗(cognitive behavior therapy for insomnia

CBT-I)联合催眠治疗对伴有焦虑的慢性失眠患者的治疗效果。

方法

将重庆市妇幼保健院心理门诊2018年3-5月的轻中度焦虑的慢性失眠患者48例按照随机数字表法分为观察组和对照组，每组各24例，观察组和对照组分别给予6周催眠联合CBT-I治疗和传统CBT-I治疗，在干预前，干预结束后即刻、1个月、3个月，采用宗氏焦虑自评量表(Self-Rating Anxiety Scale

SAS)和匹兹堡睡眠指数(Pittsburgh Sleep Quality Index

PSQI)量表对患者焦虑情绪及睡眠状况进行调查，并使用心肺耦合睡眠质量评估系统(Cardiopulmonary Coupling Sleep Quality Assessment System

CPC)对患者睡眠潜伏期(sleep onset latency

SOL)、在床时间(time in bed

TIB)、总睡眠时间(total sleep time

TST)及睡眠效率(sleep efficiency，SE)情况进行评估记录。

结果

T检验结果显示，干预后观察组各时段SAS、PSQI评分均低于对照组；重复测量方差分析结果显示，观察组干预后各时段SAS、PSQI评分低于干预前(

0.05)；对照组各时段SAS评分差异无统计学意义(

0.05)，干预结束后即刻和干预结束后1个月PSQI评分低于干预前(

0.01)，而干预结束后3个月则与干预前差异无统计学意义(

0.05)。CPC结果显示，干预后观察组各时段TST、SE均高于对照组，SOL低于对照组(

0.01)，对照组SOL在干预结束后即刻降低(

0.01)，在干预结束后1、3个月SOL较干预结束后即刻有所增加(

0.01)，且干预结束后3个月TST及SE与干预前比较差异无统计学意义(

0.05)。

结论

失眠的认知行为治疗对焦虑情绪的改善作用不佳，且对睡眠的改善作用不稳定；与传统失眠的认知行为治疗相比，催眠联合失眠的认知行为治疗能显著改善失眠患者焦虑情绪及睡眠质量，且具有更长期、稳定的治疗效果，值得临床推广使用。

Abstract

Objective

To evaluate the efficacy of hypnosis combined with cognitive behavior therapy for insomnia (CBT-I) in improving the symptoms of patients with chronic insomnia and anxiety.

Methods

Between March and May

2018

48 patients with chronic insomnia and moderate anxiety were recruited from the Psychology Clinic of our center and randomized into the observation group and control group. The patients in the observation group received hypnosis therapy combined with CBT-I for 6 weeks

and those in the control group were treated with CBT-I only. The patients were assessed for anxiety level and sleep quality using Self-Rating Anxiety Scale (SAS) and Pittsburg Sleep Quality Index (PSQI) before and immediately after the intervention

and at 1 month and 3 months after the intervention; Cardiopulmonary Coupling Sleep Quality Assessment System (CPC) was used to measure the sleep onset latency (SOL)

time in bed (TIB)

total sleep time (TST) and sleep efficiency (SE) of the patients at the same time points.

Results

At each of the time points after intervention

the patients in the observation group had lower SAS and PSQI scores than those in the control group. Repeated measures analysis of variance showed that the patients in the observation group had significantly better improvement in the anxiety level and sleep quality than the control patients (

0.05). The combined therapies also significantly reduced the SOL and increased TST and SE as compared with CBT-I only (

0.05).

Conclusion

Intervention with CBT-I alone has a poor effect on anxiety and an unstable effect on insomnia. The combination of CBT-I with hypnosis can achieve significant improvements in the anxiety level and sleep quality of the patients with long-lasting and stable effects.

关键词

Keywords

references

SATEIA M J. International classification of sleep disorders-third edition: highlights and modifications[J]. Chest, 2014, 146(5): 1387-1394. DOI: 10.1378/chest.14-0970.

MORIN C M, BENCA R. Chronic insomnia[J]. Lancet, 2012, 379(9821): 1129-1141. DOI: 10.1016/s0140-6736(11)60750-2.

OHAYON M M. Epidemiology of insomnia: what we know and what we still need to learn[J]. Sleep Med Rev, 2002, 6(2): 97-111. DOI: 10.1053/smrv.2002.0186.

BUYSSE D J. Insomnia[J]. JAMA, 2013, 309(7): 706-716. DOI: 10.1001/jama.2013.193.

SOFI F, CESARI F, CASINI A, et al . Insomnia and risk of cardiovascular disease: a meta-analysis[J ] . Eur J Prev Cardiol, 2014, 21(1): 57-64. DOI: 10.1177/2047487312460020.

BAILLARGEON L, LANDREVILLE P, VERREAULT R, et al . Discontinuation of benzodiazepines among older insomniac adults treated with cognitive-behavioural therapy combined with gradual tapering: a randomized trial[J ] . CMAJ, 2003, 169(10): 1015-1020.

ROTH T, COULOUVRAT C, HAJAK G, et al . Prevalence and perceived health associated with insomnia based on DSM-Ⅳ-TR; International statistical classification of diseases and related health problems, tenth revision; and research diagnostic criteria/international classification of sleep disorders, second edition criteria: results from the america insomnia survey[J ] . Biol Psychiatry, 2011, 69(6): 592-600. DOI: 10.1016/j.biopsych.2010.10.023.

EIDELMAN P, TALBOT L, IVERS H, et al . Change in dysfunctional beliefs about sleep in behavior therapy, cognitive therapy, and cognitive-behavioral therapy for insomnia[J ] . Behav Ther, 2016, 47(1): 102-115. DOI: 10.1016/j.beth.2015.10.002.

JACOBS G D, PACE-SCHOYTT E F, STICKGOLD R, et al . Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison[J ] . Arch Intern Med, 2004, 164(17): 1888-1896. DOI: 10.1001/archinte.164.17.1888

EDINGER J D, WOHLGEMUTH W K, RADTKE R A, et al .Cognitive behavioral therapy for treatment of chronic primary insomnia:a randomized controlled trial[J ] . JAMA, 2001, 285(14): 1856-1864. DOI: 10.1001/jama.285.14.1856

FLAMMER E, ALLADIN A. The efficacy of hypnotherapy in the treatment of psychosomatic disorders: meta-analytical evidence[J]. Int J Clin Exp Hypn, 2007, 55(3): 251-274. DOI: 10.1080/00207140701338696.

QASEEM A, KANSAGARA D, FORCIEA MA, et al . Management of chronic insomnia disorder in adults: a clinical practice guideline from the american college of physicians[J ] . Ann Intern Med, 2016, 165(2): 125-133. DOI:10.7326/M15-2175.

刘贤臣, 唐茂芹, 胡蕾, 等.匹兹堡睡眠质量指数的信度和效度研究[J].中华精神科杂志, 1996(29): 103-107.

LIU X C, TANG M Q, HU L, et al . Reliability and validity of the pittsburgh sleep quality index[J ] . Chin J Psychiatry, 1996(29): 103-107.

SCHLARB A A, FRIEDRICH A, CLABEN M. Sleep problems in university students - an intervention[J]. Neuropsychiatr Dis Treat, 2017, 13: 1989-2001. DOI: 10.2147/NDT.S142067.

CORDI M J, SCHLARB A A, RASCH B. Deepening sleep by hypnotic suggestion[J]. Sleep, 2014, 37(6): 1143-1152F. DOI: 10.5665/sleep.3778.

MENDOZA M E, CAPAFONS A, GRALOW J R, et al . Randomized controlled trial of the Valencia model of waking hypnosis plus CBT for pain, fatigue, and sleep management in patients with cancer and cancer survivors[J ] . Psycho-Oncology, 2017, 26(11): 1832-1838. DOI: 10.1002/pon.4232.

CARMODY T P, DUNCAN C L, SOLKOWITZ S N, et al . Hypnosis for smoking relapse prevention: a randomized trial[J ] . Am J Clin Hypn, 2017, 60(2): 159-171. DOI: 10.1080/00029157.2016.1261678.

LIOSSI C, WHITE P, HATIRA P. A randomized clinical trial of a brief hypnosis intervention to control venepuncture-related pain of paediatric cancer patients[J]. Pain, 2009, 142(3): 255-263. DOI: 10.1016/j.pain.2009.01.017.

KOFFEL E A, KOFFEL J B, GEHRMAN P R. A meta-analysis of group cognitive behavioral therapy for insomnia[J]. Sleep Med Rev, 2015, 19: 6-16. DOI: 10.1016/j.smrv.2014.05.001.

MITCHELL M D, GEHRMAN P, PERLIS M, et al . Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review[J ] . BMC Fam Pract, 2012, 13: 40. DOI:10.1186/1471-2296-13-40.

CORDI M J, HIRSIGER S, M RILLAT S, et al . Improving sleep and cognition by hypnotic suggestion in the elderly[J ] . Neuropsychologia, 2015, 69: 176-182. DOI:10.1016/j.neuropsychologia.2015.02.001.

GOONERATNE N S, VITIELLO M V. Sleep in older adults: normative changes, sleep disorders, and treatment options[J]. Clin Geriatr Med, 2014, 30(3): 591-627. DOI: 10.1016/j.cger.2014.04.007.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

新兵职业认同和焦虑、抑郁、失眠的相关关系变化研究

上海方舱医院新型冠状病毒感染者焦虑、抑郁、失眠状况及影响因素调查研究

正念注意觉知在抑郁合并失眠患者知觉压力与抑郁情绪间的中介作用

诊断告知/隐瞒对早、中期肝癌患者的焦虑、抑郁及疾病感知的影响

基于网络的接纳与承诺疗法对精神健康影响的Meta分析