A Study On The Efficacy And Factors That Influence Compliance With Cognitive-behavioral Therapy Of Primary Insomnia

Experiment1Objective: Cognitive-behavior therapy for insomnia (CBT-I) has demonstratedefficacy for the treatment of primary insomnia. Despite the strong evidence supportingthe efficacy of CBT-I, little is known about factors related to attrition during treatment.The aim of the present study was to identify characteristics of patients who are at riskfor dropout from a four-session group CBT-I in a clinical setting.Methods:(1)44patients with primary insomnia and44normal controls matchedby age and sex were evaluated with following questionnaires: HAMA, HAMD, PSQI,dysfunctional beliefs and attitudes about sleep scale, coping style questionnaire scale.The study analyzed the differences between the two groups.(2)The analysis ofcompliance of factors was conducted on the subjects between the patients who completetreatment and did not complete treatment.(3)All subjects (sleep onset latency, morningwake time, sleep efficiency, and wake time after sleep onset) measured all of the abovequestionnaires, and the study compared the curative effect before and after thetreatment.Results:(1) The results revealed that patients who reported a short time in bed(TIB) were at greatest risk for termination.(2)The score of HAMA、HAMD、PSQI、dysfunctional beliefs and attitudes about sleep scale, coping style questionnaire scale inprimary insomniacs notably differed from that of normal controls.(3)The score ofSleep-related data by patients who complete treatment after the treatment differed fromthat before the treatment.Conclusion:(1)These findings indicate that long TIB at baseline are associatedwith increased risk of termination from CBT-I.（2）There were more questions onanxiety, depression and more wrong beliefs about and attitude towards sleep in insomniacs than that of healthy people.（3）The mental health and sleep quality ofinsomniacs were improved after CBT-I. Experiment2Objective: That is common primary insomnia patients taking hypnotic drug, butthe drug side effects were gradually emerge with the extension of treatment time and theincrease in drug doses. The aim of the present study was to identify hypnotic reductioninstructions following a session of cognitive-behavior therapy for insomnia (CBT-I).Methods:(1)44patients with primary insomnia were given the treatment ofCBT-I. All hypnotic usages were measured before treatment and3months aftertreatment.Results: CBT-I had greater improvements in hypnotic medication usage. Of the44patients with primary insomnia,29patients have taking hypnotic drugs.4(13.79%)patients reduce the dosage of hypnotic medication and the ratio of dropped medicationwas65.52%.Conclusion: Primary insomniacs, in particular the patients who completetreatment could reduce the dosage of hypnotic by received CBT-I.