불면증에 대한 인지행동치료 효과 연구 : 공존 불면증 환자를 대상으로

국문 초록 (Abstract)

본 연구는 서울 소재의 수면전문병원에 불면증을 주소로 내원한 환자들 중 불면증 인지행동치료에 의뢰된 총 154명의 환자를 대상으로 하였다. 이들은 불면증에 더하여 수면호흡장애와 하지불안증후군을 함께 갖고 있는 공존 불면증 환자들로서, 우울 및 불안을 포함한 전반적인 심리적 고통 수준 또한 높은 것으로 나타났다. 이들 중 124명(남: 26명, 여: 98명)은 5회기의 불면증 인지행동치료(1회기의 개인 인지행동치료 + 4회기의 집단 인지행동치료)를 받았고, 30명(남: 10명, 여: 20명)은 비교집단(약물치료 대기집단)에 배정되었다. 치료집단과 비교집단의 사전, 사후 평가를 분석한 결과, 첫째, 치료집단은 비교집단에 비하여 불면증 심각도, 수면노력, 수면에 대한 비합리적 신념 및 태도, 수면 전 각성, 걱정, 우울, 불안, 자살사고, 삶의 질, 그리고 실제적인 수면(총 수면 시간, 수면잠복기, 수면효율성)에 있어서 유의한 개선을 보여, 불면증 인지행동치료의 치료효과가 검증되었다. 둘째, 불면증 인지행동치료의 효과가 치료 후에도 잘 유지되는지 살펴보기 위하여 치료집단을 대상으로 1개월 후 추후 평가를 실시한 결과, 수면 중 각성 횟수와 주간 유도제 복용 횟수를 제외한 나머지 모든 변인들, 즉 불면증 심각도, 수면노력, 수면에 대한 비합리적 신념 및 태도, 수면 전 각성, 걱정, 우울, 불안, 자살사고, 삶의 질, 실제적인 수면(총 수면 시간, 수면잠복기, 수면효율성)에 있어서 치료 효과가 지속되는 것으로 나타났다. 본 연구의 결과를 바탕으로 임상적 의의와 제한점에 대해 논하였다.

다국어 초록 (Multilingual Abstract)

Chronic insomnia is a very common disorder, and comorbid insomnia is much more prevalent than primary insomnia, however it has not received sufficient attention. Especially sleep breathing disorder (SBD) and restless legs syndrome (RLS) have shown high comorbidity with insomnia. The purpose of this study was to examine whether cognitive behavioral therapy for Insomnia (CBT-I) would be effective for clinical insomnia patients who visited a sleep clinic located in Seoul. Results were as follows: First, compared to the comparison group, the treatment group achieved better insomnia severity, sleep effort, dysfunctional beliefs and attitudes about sleep, pre-sleep arousal, worry, depression, anxiety, suicidal idea, quality of life, and sleep measures (self-report of total sleep time, sleep latency, sleep efficacy). Therefore, this study showed the effectiveness of CBT-I for chronic insomnia patients comorbid with SDB and RLS. Second, in order to find out maintenance of the treatment benefits of CBT-I, one-month follow-up session was conducted. The results showed that with exception of times of arousal after sleep onset and times of weekly sleep medication intake, the treatment effect on the other outcome variables, such as insomnia severity, sleep effort, dysfunctional beliefs and attitudes about sleep, pre-sleep arousal, worry, depression, anxiety, suicidal idea, quality of life, and sleep measures (self-report of total sleep time, sleep latency, sleep efficacy), were sustained.

목차 (Table of Contents)

• 요약
• 방법
• 연구대상
• 연구도구
• 연구절차
• 본 연구의 인지행동치료 치료자
• 자료분석
• 결과
• 인구통계학적 특성
• 논의
• 참고문헌
• Abstract

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