Effect of cognitive behavioural therapy and yoga for generalised anxiety disorder on sleep quality in a randomised controlled trial: the role of worry, mindfulness, and perceived stress as mediators.

Autor: Jacoby RJ; Massachusetts General Hospital/Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA., Brown ML; University of Louisville, Department of Psychology, Louisville, Kentucky, USA., Wieman ST; Suffolk University, Department of Psychology, Boston, Massachusetts, USA., Rosenfield D; Southern Methodist University, Department of Psychology, Dallas, Texas, USA., Hoeppner SS; Massachusetts General Hospital/Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA., Bui E; Normandie Univ, UNICAEN, INSERM, U1237, PhIND 'Physiopathology and Imaging of Neurological Disorders', NEUROPRESAGE Team, Institut Blood and Brain at Caen-Normandie, GIP Cyceron, Caen, France and Centre Hospitalier Universitaire Caen Normandie, Caen, France., Hoge EA; Georgetown University Medical Center, Department of Psychiatry, Washington, DC, USA., Khalsa SBS; Brigham and Women's Hospital/Harvard Medical School, Division of Sleep and Circadian Disorders, Department of Medicine, Boston, Massachusetts, USA., Hofmann SG; Philipps-University Marburg, Department of Clinical Psychology, Marburg/Lahn, Germany., Simon NM; New York University Grossman School of Medicine, Department of Psychiatry, New York, New York, USA.
Jazyk: angličtina
Zdroj: Journal of sleep research [J Sleep Res] 2024 Feb; Vol. 33 (1), pp. e13992. Date of Electronic Publication: 2023 Aug 14.
DOI: 10.1111/jsr.13992
Abstrakt: Sleep disturbances are present in ~65% of individuals with generalised anxiety disorder (GAD). Although both Kundalini yoga (KY) and cognitive behavioural therapy (CBT) are effective treatment options for GAD, little is known about how these treatments compare in improving sleep for GAD and what drives these changes. Accordingly, we examined the effects of CBT, KY, and stress education (SEdu; an attention control condition) on subjective sleep quality (as measured by the Pittsburgh Sleep Quality Index [PSQI] and Insomnia Severity Index [ISI]) in a randomised controlled trial of 226 adults with GAD (mean age 33.37 years; 70% female; 79% White). We hypothesised that both CBT and KY would outperform SEdu in improving sleep disturbances. Three potential mediators of sleep improvement (worry, mindfulness, perceived stress) were also examined. In line with hypotheses, PSQI and ISI scores significantly improved from pre- to post-treatment for all three treatment groups (all p < 0.001, all d > 0.97). However, contrary to predictions, sleep changes were not significantly greater for CBT or KY compared to SEdu. In mediation analyses, within-person deviations in worry, mindfulness, and stress each significantly mediated the effect of time on sleep outcomes. Degree of change in sleep attributable to worry (CBT > KY > SEdu) and perceived stress (CBT, KY > SEdu) was moderated by treatment group. Personalised medicine as well as combined treatment approaches should be studied to help reduce sleep difficulties for patients with GAD who do not respond.
(© 2023 European Sleep Research Society.)
Databáze: MEDLINE
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