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The Differences in Sleep Skills between Insomnia Patients with and without Need of Hypnotics

Sleep Medicine Research 2020년 11권 2호 p.88 ~ 93
공병훈, 고미애, 장진구, 홍민하, 김우정, 이수영, 김현수, 송후림,
소속 상세정보
공병훈 ( Kong Byung-Hoon ) - Hanyang University Medical Center Myongji Hospital Department of Psychiatry
고미애 ( Ko Mi-Ae ) - Hanyang University Medical Center Myongji Hospital Department of Psychiatry
장진구 ( Chang Jhin-Goo ) - Hanyang University Medical Center Myongji Hospital Department of Psychiatry
홍민하 ( Hong Min-Ha ) - Hanyang University Medical Center Myongji Hospital Department of Psychiatry
김우정 ( Kim Woo-Jung ) - Hanyang University Medical Center Myongji Hospital Department of Psychiatry
이수영 ( Lee Su-Young ) - Hanyang University Medical Center Myongji Hospital Department of Psychiatry
김현수 ( Kim Hyun-Soo ) - Hanyang University Medical Center Myongji Hospital Department of Psychiatry
송후림 ( Song Hoo-Rim ) - Hanyang University Medical Center Myongji Hospital Department of Psychiatry

Abstract


Background and Objective: Hypnotics are widely prescribed for the treatment of insomnia; however, cognitive behavioral therapy for insomnia (CBT-I) is considered as a primary treatment. We checked ordinary sleep skills of insomnia patients and changes in sleep skills after CBT-I, and evaluated the difference in sleep skills between patients with and without need of hypnotics.

Methods: A total of 131 outpatients who had visited our sleep clinic with insomnia were recruited. Enrollment criteria included at least 12 weeks of insomnia periods, less than 16 in Beck Depression Inventory score, and agreement to receive 9 sessions of CBT-I for 12 weeks. After 12 weeks of CBT-I, patients were divided into two groups: still in need and no need of hypnotics. Changes in sleep skills were compared between these groups.

Results: Sleep hygiene, sleep stimulus-control skills, and sleep Visual Analogue Scales (VAS) were statistically improved after CBT-I (all, p < 0.001). Forty-six (35.1%) patients did not need hypnotics anymore; however, 85 (64.9%) still needed hypnotics after CBT-I. Sleep VAS (25.26 ± 8.52 vs. 32.64 ± 8.95, p < 0.001), practicing regular moderate exercise (3.67 ± 0.92 vs. 2.76 ± 1.06, p = 0.030), and having a relaxing bedtime routine (4.08 ± 0.55 vs. 2.76 ± 0.76, p < 0.001) were different in the two groups.

Conclusions: Among CBT-I skills, regular moderate exercise and a relaxing bedtime routine seem to be key components. For reducing chronic use of hypnotics, and better outcome of CBT-I, clinicians should focus more on these two components.

키워드

Cognitive bahavioral therapy; Insomnia; Hypnotics

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