Development trajectory of sleep quality and its influencing factors in patients with insomnia after CBT-I treatment
10.3760/cma.j.cn371468-20250325-00112
- VernacularTitle:失眠患者CBT-I治疗后睡眠质量发展轨迹及其影响因素
- Author:
Shuchuan ZHENG
1
;
Yanyu HU
;
Peng LAI
;
Xueyi DUAN
Author Information
1. 厦门市仙岳医院睡眠医学中心，厦门医学院附属仙岳医院，福建省精神医学中心，福建省精神疾病临床医学研究中心，厦门 361012
- Publication Type:Journal Article
- Keywords:
Insomnia;
Cognitive behavioral therapy;
Sleep quality;
Development trajectory
- From:
Chinese Journal of Behavioral Medicine and Brain Science
2025;34(7):618-624
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the development trajectory of sleep quality in patients with insomnia after cognitive behavioral therapy (CBT-I), and to explore the influencing factors of different development trajectories.Methods:A total of 418 patients with insomnia who received CBT-I at the Sleep Medicine Center of Xiamen Xianyue Hospital from February 2019 to June 2023 were recruited using convenience sampling. All patients completed the Pittsburgh sleep quality index (PSQI) at five time points: before CBT-I initiation (T1), at the end of treatment (T2), and at 3 months (T3), 6 months (T4), and 12 months (T5) post-treatment. At T1, all patients were evaluated by the insomnia severity index (ISI), Flinders fatigue scale (FFS), Beck depression inventory-Ⅱ (BDI-Ⅱ), Beck anxiety inventory (BAI), and dysfunctional beliefs and attitudes about sleep scale (DBAS). Latent class growth modeling (LCGM) was constructed and employed to analyze the development trajectories of sleep quality post-CBT-I using Mplus 8.0 software. Univariate analysis and Logistic regression analysis were conducted by SPSS 26.0 software to explore influencing factors of the sleep quality trajectories.Results:The PSQI scores of insomnia patients at T1, T2, T3, T4 and T5 were 15(12, 18), 8(6, 11), 5(3, 7), 5(3, 7) and 5(2, 7), respectively. Three distinct development trajectories were identified. Based on these trajectories, 418 patients were categorized into fluctuating development group ( n=44, 10.53%), slow improvement group ( n=193, 46.17%), and sustained improvement group ( n=181, 43.30%). Logistic regression analysis revealed that depressive symptom severity, anxiety symptom severity, family history of insomnia, and use of hypnotic medications were significant influencing factors for the sleep quality trajectories after CBT-I treatment (all P<0.05). Conclusion:The sleep quality of insomnia patients after CBT-I treatment shows different development trajectories, and its influencing factors are depression, anxiety, family history of insomnia and the use of hypnotic medications.
