团体失眠认知行为疗法治疗阻塞性睡眠呼吸暂停共病失眠1例  

Group cognitive behavioral therapy for insomnia in the treatment of comorbid insomnia and obstructive sleep apnea:a case report

作　　者：刘敏 赵瑞 陈敏 苏日娜[1] 魏婉婷 姚萍 吕东升 Liu Min;Zhao Rui;Chen Min;Su Rina;Wei Wanting;Yao Ping;Lyu Dongsheng(Inner Mongolia Autonomous Region Mental Health Center,Hohhot 010010,China)

机构地区：[1]内蒙古自治区精神卫生中心,内蒙古呼和浩特010010

出　　处：《四川精神卫生》2024年第6期572-575,共4页Sichuan Mental Health

基　　金：中央引导地方科技发展资金项目(项目名称:失眠障碍患者接受失眠认知行为治疗的临床疗效及神经影像学机制研究,项目编号:2022ZY0028)。

摘　　要：本文报道1例以失眠为主诉就诊的患者,多导睡眠监测(PSG)结果显示存在重度阻塞性睡眠呼吸暂停(OSA)。患者尝试接受持续气道正压通气治疗(CPAP),因感觉戴带呼吸机后入睡更加困难而放弃,后仅接受团体失眠认知行为治疗(CBT-I),失眠症状得到改善,OSA也由重度降为轻度。这一案例提示:(1)由于失眠与OSA具有较高的共病率,在失眠障碍患者的临床诊疗过程中,应注意对OSA的评估;(2)CBT-I能够通过改善失眠,缓解阻塞性睡眠呼吸暂停与失眠共病(COMISA)患者的夜间呼吸暂停和日间嗜睡症状,在对此类患者的治疗中,应重视CBT-I的应用。This article reported a patient who initially presented with insomnia complaints and was subsequently diagnosed with severe obstructive sleep apnea(OSA) on polysomnography(PSG).The patient tried continuous positive airway pressure(CPAP)but gave up because wear the ventilator made it more difficult to fall asleep.Then the patient only received group cognitive behavioral therapy for insomnia(CBT-I),which not only alleviated insomnia severity but also promoted severe OSA into mild status.Such case suggested that,firstly,due to the high comorbidity of insomnia and OSA,evaluation of OSA should be considered a part worth enough attention of the clinical diagnosis and treatment of insomnia patients.Secondly,by relieving insomnia,CBT-I can alleviate both nocturnal apnea and daytime somnolence in patients with comorbid insomnia and sleep apnoea(COMISA),so the application of CBT-I should be emphasized in the treatment of such patients.

关 键 词：团体失眠认知行为疗法 失眠 阻塞性睡眠呼吸暂停 

分 类 号：R749[医药卫生—神经病学与精神病学]