| ObjectiveThe clinical efficacy of low resistance Thought Induction Psychotherapy for Insomnia(TIPI)and Progressive Muscle Relaxation(PMR)in the treatment of insomnia disorder and the differences between subjective and objective sleep were observed and compared,which provided a reference and basis for the treatment of clinical insomnia and provided a basis for its application and promotion.MethodsAccording to the inclusion and exclusion criteria,a total of 64 patients with insomnia were included and were divided into TIP-I intervention group and PMR control group according to random number scale.A total of 5 cases were shed during the intervention,including 1 case in the intervention group,4 cases in the control group,and finally 59 cases were completed,of which 22 patients in each group were randomly selected for polysomnography(PSG),of which 21 cases were completed in the intervention group,1 case was shed,and all 22 cases were completed in the control group.The intervention group was treated with TIP-I and the control group with PMR.After signing the informed consent form,32 patients were randomly assigned to the TIP-I intervention group and 32 patients to the PMR control group by generating a random number table using SPSS.At the same time,22 patients from each group were randomly selected for PSG examination.Both groups were intervened for 4 weeks,received offline treatment twice a week,and were given corresponding training audio for self-training after returning home.Examinations such as polysomnography(PSG),insomnia severity scale(ISI),Pittsburgh Sleep Quality Index(PSQI),Hamilton Depression Scale(HAMD),and Hamilton Anxiety Scale(HAMA)were performed at weeks 0 and 4 of treatment,respectively.Excel2016 and SPSS26.0 were used to establish a questionnaire screening and statistical analysis database to analyze and compare the scores of PSG,ISI,PSQI,HAMD and HAMA before and after treatment,and clarify the similarities and differences between TIP-I and PMR in the intervention of patients with insomnia disorders.Results1 Basic situationThe gender(χ2=1.699,P=0.192),age(Z=1.389,P=0.165),years of education(Z=-1.797,P=0.072)and disease course distribution(Z=0.977,P=0.329)of subjects in the two groups were compared,P>0.05.The difference was not statistically significant and the two groups were comparable.ISI(t=0.362,P=0.719),PSQI(t=-1.924,P=0.059),PSG(TST:Z=0.583,P=0.560;SE:Z=-0.535,P=0.593),HAMD(Z=0.259,P=0.796),and HAMA(t=-1.922,P=0.060)baseline scores,P>0.05,the difference of baseline scores was not statistically significant,and the two groups were comparable.2 Clinical efficacy evaluationTaking PSQI reduction rate as the evaluation index,the effective rate of TIP-I intervention group was 87.1%.The effective rate of PMR control group was 78.6%.The average level of effective rate between the two groups was statistically significant,Z=2.216,P<0.05.3 Comparison of ISI resultsAfter treatment,ISI scores in TIP-I intervention group were lower than those in PMR control group,and the difference was statistically significant,Z=-1.985,P=0.047,P<0.05.Intra-group comparison showed that ISI scale scores in the intervention group(Z=4.864,P=0.000)and the control group(Z=4.626,P=0.000)were significantly reduced before and after treatment,with statistical significance(P<0.05).4 Comparison of PSQI resultsAfter treatment,the total score of PSQI(Z=-3.374,P=0.001),time to fall asleep(Z=2.168,P=0.030),total sleep time(Z=-2.005,P=0.045),daytime dysfunction(Z=-3.331,P=0.003)was lower than that of PMR control group,with statistical significance(P<0.05).Intra-group comparison showed that the total score of PSQI scale and scores of each component in both groups were significantly reduced before and after treatment,with statistical significance(P<0.05).5 Comparison of PSG resultCompared with PMR control group,TIP-I intervention group had shorter WASO(Z=-5.006,P=0.000),fewer awake times(AT)(t=-2.306,P=0.026),and longer total sleep time(TST)(Z=4.434,P=0.000),higher sleep efficiency(SE)(Z=4.678,P=0.000),lower percentage of N1 in sleep period(N1%)(t=-3.153,P=0.003),N2%in sleep period(Z=2.199,P=0.028)and the percentage of REM in sleep period(REM%)(t=3.693,P=0.001)were higher,while the percentage of WAKE period in sleep period(WAKE%)was lower(Z=-4.702,P=0.000),the differences were statistically significant.P<0.05.There was no significant difference in N3%between the two groups(P>0.05).In the TIP-I intervention group,WASO(Z=-3.319,P=0.001),AT(Z=-3.380,P=0.001),TST(Z=2.312,P=0.021),SE(Z=3.771,P=0.000),WAKE%(Z=-2.903,P=004)were shortened or increased,with statistical significance,P<0.05;WASO(Z=1.802,P=0.072),AT(Z=0.325,P=0.745),TST(Z=1.802,P=0.072),SE(Z=-0.325,P=0.745)before and after treatment,there was no statistical significance,P>0.05,but the difference of N2%(Z=-2.094,P=0.036)before and after treatment in the control group was statistically significant,P<0.05;The N3%(Z=3.111,P=0.002)in the intervention group(Z=2.937,P=0.003)and the control group(Z=2.937,P=0.003)before and after treatment were statistically significant(P<0.05).6 Comparison of subjective and obj ective sleep conditionsThe TIP-I intervention group had subjective and objective differences in cognition of TST(t=-4.002,P=0.000),WASO(Z=1.955,P=0.050)and SE(t=-2.667,P=0.011)before treatment,and the differences were statistically significant,P<0.05;There was no significant difference in the recognition of TST(Z=0.417,P=0.677)after treatment(P>0.05).After treatment,there were still differences in the understanding of WASO(t=2.885,P=0.006)and SE(t=-2.359,P=0.023),and the difference was statistically significant,P<0.05.Patients in PMR control group had subjective and objective differences in their understanding of TST(Z=-2.589,P=0.010),WASO(Z=3.835,P=0.000)and SE(Z=-3.358,P=0.001)before treatment,and the differences were statistically significant,P<0.05;After treatment,there were still differences in the understanding of TST(Z=2.456,P=0.014),WASO(Z=3.825,P=0.000)and SE(Z=3.199,P=0.001),and the difference was statistically significant(P<0.05).7 Comparison of HAMD and HAMA resultsAfter treatment,HAMD(t=-2.154,P=0.035)and HAMA(t=-3.111,P=0.004)scores in TIP-I intervention group were lower than those in PMR control group,and the differences in HAMD and HAMA scores between the two groups were statistically significant,P<0.05.Intra-group comparison showed that after the end of treatment intervention,the total scores of HAMD(t=9.861,P=0.000)and HAMA(t=7.640,P=0.000)scales in the intervention group and HAMD(t=4.463,P=0.000)and HAMA(t=7.924,P=0.000)in the control group were significantly reduced,with statistical significance(P<0.05).ConclusionBoth TIP-I and PMR can improve insomnia disorders.TIP-I is more effective than PMR in treating insomnia disorders.Both TIP-I and PMR can improve N3%.Compared with PMR treatment,TIP-I treatment has a better effect on improving the severity of subjective insomnia symptoms,total sleep time,time of sleep onset,and daytime dysfunction in people with insomnia disorder.TIP-I can shorten WASO,increase TST,increase SE and reduce AT.The adjustment of sleep structure by TIP-I is more reasonable,which is more conducive to the adjustment of TST’s subjective and objective sleep perception consistency and better emotional regulation for insomnia patients. |
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