实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (8): 808-812.doi: 10.3969/j.issn.1003-9198.2025.08.011

• 临床研究 • 上一篇    下一篇

数字化失眠认知行为治疗对老年抑郁病人睡眠质量和认知功能的影响

孙奕, 卜玲, 宫钦浩, 王变荣, 黄丹青, 郑慧芬   

  1. 210029 江苏省南京市,江苏卫生健康职业学院临床医学院(孙奕,卜玲,宫钦浩);
    210024 江苏省南京市,江苏省省级机关医院神经内科(王变荣,黄丹青,郑慧芬)
  • 收稿日期:2024-12-14 发布日期:2025-08-19
  • 通讯作者: 郑慧芬,Email:zhenghuifen＠163.com
  • 基金资助:
    江苏省卫生健康发展研究中心开放课题(JSHD202324);江苏省卫生健康委员会科研项目(H2019052)

Effect of digital cognitive behavioral therapy for insomnia on sleep quality and cognitive function in elderly patients with depression and insomnia

SUN Yi,BU Ling, GONG Qinhao, WANG Bianrong, HUANG Danqing, ZHENG Huifeng   

  1. School of Clinical Medicine, Jiangsu Health Vocational College, Nanjing 210029,China (SUN Yi,BU Ling, GONG Qinhao);
    Department of Neurology, Jiangsu Province Official Hospital,Nanjing 210024,China (WANG Bianrong,HUANG Danqing,ZHENG Huifen)
  • Received:2024-12-14 Published:2025-08-19
  • Contact: ZHENG Huifen, Email:zhenghuifen＠163.com

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摘要： 目的 探讨数字化失眠认知行为疗法( dCBT-I) 对老年抑郁合并失眠病人睡眠质量和认知功能的影响。 方法 选取2021年10月至2023年6月江苏省省级机关医院门诊及住院治疗的抑郁合并失眠病人43例,其中早发型抑郁(EOD)组20例,晚发型抑郁(LOD)组23例,均给予为期6周的dCBT-I治疗,治疗前后分别行多维度神经心理学量表评估及主客观睡眠质量分析。 结果 dCBT-I干预后,2组汉密尔顿抑郁量表17项(HAMD-17)评分均下降;LOD组听觉词语学习测验(AVLT)的延迟回忆词语数较干预前显著增加,画钟测验(CDT)和连线测验(TMT)评分明显优于干预前,差异均有统计学意义(P<0.05);EOD组AVLT的延迟回忆亦较干预前好转(P<0.05),其余认知指标无明显变化。干预后,2组匹兹堡睡眠质量指数(PSQI)得分、总睡眠时间、睡眠效率以及非快速眼动睡眠3期比例均明显增加,与干预前比较,差异均有统计学意义(P<0.05)。 结论 dCBT-I在改善老年抑郁症病人抑郁症状的同时也改善了病人的睡眠质量和部分认知功能,尤其是LOD病人的延迟回忆、执行功能。

关键词: 早发型抑郁症, 晚发型抑郁症, 数字化失眠认知行为治疗, 失眠

Abstract: Objective To investigate the effect of digital cognitive behavioral therapy for insomnia (dCBT-I) on sleep quality and cognitive function in the elderly patients with depression and insomnia. Methods A total of 43 elderly patients with depression and insomnia treated in Jiangsu Province Official Hospital from October 2021 to June 2023 were enrolled, including 20 patients with early-onset depression (EOD group) and 23 patients with late-onset depression (LOD group). All patients received dCBT-I for 6 weeks, and their cognitive function and subjective and Objective sleep quality were evaluated before and after treatment. Results After dCBT-I intervention, the scores of 17-item Hamilton Depression Rating Scale (HAMD-17) in the two groups were reduced significantly (P<0.05). The number of delayed recall words in the auditory verbal learning test (AVLT) in LOD group was significantly more than that before intervention, and the scores of clock Drawing test (CDT) and trail making test (TMT) were significantly better than those before intervention (P<0.05). AVLT delayed recall was significantly improved in EOD group, but other cognitive metrics showed no significant changes. Pittsburgh Sleep Quality Index (PSQI) score, prolonged total sleep time, enhanced sleep efficiency, and the proportion of non-rapid eye movement sleep stage 3 were significantly increased in the two groups. Conclusions dCBT-I can effectively alleviate depressive symptoms, improving sleep quality and specific cognitive functions in the elderly patients with depression, especially enhancing delayed recall and executive function in LOD patients.

Key words: early-onset depression, late-onset depression, digital cognitive behavioral therapy for insomnia, insomnia

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