睡眠時無呼吸症候群患者の不眠症は、認知行動療法と運動トレーニングで管理可能であることが判明(Insomnia in patients with sleep apnea can be managed with cognitive behavioural therapy and exercise training, Concordia study finds)

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2024-09-24 カナダ・コンコーディア大学

コンコルディア大学の研究によると、慢性不眠症と閉塞性睡眠時無呼吸(COMISA)の患者には、認知行動療法(CBTi)と運動トレーニングの組み合わせが効果的です。16週間の研究で、CBTiと運動を組み合わせたグループは、運動のみのグループよりも不眠症の症状が大幅に改善されました。自己報告による主観的な睡眠質の改善は確認されましたが、客観的な睡眠パラメーターには大きな変化が見られませんでした。

<関連情報>

閉塞性睡眠時無呼吸症候群における慢性不眠症の管理に対する認知行動療法と運動トレーニングの併用と運動トレーニング単独のパイロット無作為化試験
A Pilot Randomized Trial of Combined Cognitive-Behavioral Therapy and Exercise Training Versus Exercise Training Alone for the Management of Chronic Insomnia in Obstructive Sleep Apnea

Amanda Cammalleri,Aurore A. Perrault ,Alexandra Hillcoat,Emily Carrese-Chacra,Lukia Tarelli,Rahul Patel,Marc Baltzan,Florian Chouchou,Thien Thanh Dang-Vu,Jean-Philippe Gouin, and Veronique Pepin
Journal of Sports and Exercise Psychology  Published:25 Apr 2024
DOI:https://doi.org/10.1123/jsep.2023-0139

Insomnia treatment among individuals with comorbid insomnia and obstructive sleep apnea is suboptimal. In a pilot randomized controlled trial, 19 individuals with comorbid insomnia and obstructive sleep apnea were allocated to one of two arms: EX + EX, consisting of two 8-week phases of exercise training (EX), or RE + CBTiEX, encompassing 8 weeks of relaxation training (RE) followed by 8 weeks of combined cognitive-behavioral therapy and exercise (CBTiEX). Outcomes included Insomnia Severity Index (ISI), polysomnography, and cardiorespiratory fitness measures. A mixed-model analysis of variance revealed a Group × Time interaction on peak oxygen consumption change, F(1, 14) = 10.1, p = .007, and EX increased peak oxygen consumption (p = .03, g′ = -0.41) and reduced ISI (p = .001, g′ = 0.82) compared with RE (p = .49, g = 0.16) post-8 weeks. Post-16 weeks, there was a significant Group × Time interaction (p = .014) driven by RE + CBTiEX yielding a larger improvement in ISI (p = .023, g′ = 1.48) than EX + EX (p = .88, g′ < 0.1). Objective sleep was unchanged. This study showed promising effects of regular EX alone and combined with cognitive-behavioral therapy for insomnia on ISI in comorbid insomnia and obstructive sleep apnea.

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