Terapia cognitivo-comportamental na insônia

Autores

  • Regina Margis Psiquiatra (área de atuação: medicina do sono). Membro docente, Núcleo de Estudos e Atendimento em Psicoterapias Cognitivas, Porto Alegre, RS. Mestrado em Bioquímica e Doutorado em Ciências Médicas, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS. Vicecoordenadora, Departamento de Medicina do Sono, ABP. Pesquisadora do Grupo de Pesquisa em Cronobiologia Experimental/Modelos Animais e Cronobiologia Experimental Aplicada à Saúde, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS.

DOI:

https://doi.org/10.25118/2236-918X-5-5-4

Palavras-chave:

Psychotherapy, cognitive behavioral therapy, insomnia

Resumo

A insônia é o transtorno do sono mais frequente na população. Diferentes modelos têm sido propostos para explicar a ocorrência de insônia (por exemplo, o modelo de Spielman, o modelo neurocognitivo e o modelo de inibição psicobiológica, entre outros). Conhecer tais modelos contribui para uma melhor compreensão dos mecanismos a serem avaliados e tratados. O tratamento psicoterápico tem sido amplamente pesquisado. Em especial, a terapia cognitivo-comportamental para insônia tem tido sua eficácia demonstrada em diferentes estudos, sendo intervenção recomendada para indivíduos com insônia. Diferentes abordagens, como a terapia de controle de estímulos, restrição de sono, terapia cognitiva e terapia cognitiva baseada em mindfulness, têm sido utilizadas, com benefícios observados no tratamento. Entretanto, uma parcela de indivíduos não responde plenamente às abordagens, aspecto que merece a atenção de profissionais e pesquisadores.

Downloads

Não há dados estatísticos.

Métricas

Carregando Métricas ...

Referências

Lichstein KL, Taylor DJ, McCrae CS, Ruiter ME. Insomnia: epidemiology and risk factors. In: Kryger MH, Roth T, Dement WC, editors. Principles and practice of sleep medicine. 5th ed. Philadelphia: Elsevier Saunders; 2011. p. 827-37.

Bootzin RR. Stimulus control treatment for insomnia. In: Proceedings 80th Annual Convention of the American Psychological Association; 1972; Honolulu, Hawaii, USA. p. 395-6.

Morin CM, Bootzin RR, Buysse DJ, Edinger JD, Espie CA, Lichstein KL. Psychological and behavioral treatment of insomnia: update of the recent evidence (1998-2004). Sleep. 2006;29:1398-419.

Spielman AJ, Caruso L, Glovinsky P. A behavioral perspective on insomnia. Psychiatr Clin North Am. 1987;10:541-53.

Spielman AJ, Saskin P, Thorpy MJ. Treatment of chronic insomnia by restriction of time in bed. Sleep. 1987;10:45-56.

Perlis ML, Giles E, Mendelson WB, Bootzin RR, Wyatt JK. Psychophysiological insomnia: the behavioural model and a neurocognitive perspective. J Sleep Res. 1997;6:179-88.

Perlis ML, Smith MT, Orff HJ, Andrews PJ, Giles DE. The mesograde amnesia of sleep may be attenuated in subjects with primary insomnia. Physiol Behav. 2001;74:71-6.

Harvey AG. A cognitive model of insomnia. Behav Res Ther, 2002;40:869-93.

Wicklow A, Espie CA. Intrusive thoughts and their relationship to actigraphic measurement of sleep: towards a cognitive model of insomnia. Behav Res Ther. 2000;38:679-93.

Espie CA, Broomfield NM, MacMahon MA, Macphee LM, Taylor LM. The attentionintention-effort pathway in the development of psychophysiologic insomnia: a theoretical review. Sleep Med Rev. 2006;10:215-45.

Lundh LG, Broman JE. Insomnia as an interaction between sleep-interfering and sleep-interpreting processes. J Psychosom Res. 2000;49:299-310.

Geiger-Brown JM, Rogers VE, Liu W, Ludeman EM, Downton KD, Diaz-Abad M. Cognitive behavioral therapy in persons with comorbid insomnia: a meta-analysis. Sleep Med Rev. 2014;23C:54-67.

Mitchell MD, Gehrman P, Perlis M, Umscheid CA. Comparative effectiveness of cognitive behavioraltherapy for insomnia: a systemati c review. BMC Fam Pract. 2012;13:40.

Morin CM, Culbert JP, Schwartz SM. Nonpharmacological interventi ons for insomnia: a meta-analysis of treatment effi cacy. Am J Psychiatry. 1994;151:1172-80.

Morin CM, Vallières A, Guay B, Ivers H, Savard J, Mérett e C, et al. Cogniti ve behavioral therapy, singly and combined with medicati on, for persistent insomnia: a randomized controlled trial. JAMA. 2009;301:2005-15.

Morin CM. Psychological and behavioral treatments for insomnia I: approaches and effi cacy. In: Kryger MH, Roth T, Dement WC, editors. Principles and practi ce of sleep medicine. 5th ed. Philadelphia: Elsevier Saunders; 2011. p. 866- 83.

Murtagh DR, Greenwood KM. Identi fying eff ecti ve psychological treatments for insomnia: a meta-analysis. J Consult Clin Psychol. 1995;63:79-89.

Pech M, O’Kearney R. A randomized controlled trial of problem-solving therapy compared to cogniti ve therapy for the treatment of insomnia in adults. Sleep. 2013;36:739-49.

Koff el EA, Koff el JB, Gehrman PR. A metaanalysis of group cogniti ve behavioral therapy for insomnia. Sleep Med Rev. 2015;19:6-16.

Bowen S, Witkiewitz K, Clifasefi SL, Grow J, Chawla N, Hsu SH, et al. Relati ve effi cacy of mindfulness-based relapse preventi on, standard relapse preventi on, and treatment as usual for substance use disorders: a randomized clinical trial. JAMA Psychiatry. 2014;71:547-56.

Kocovski NL, Fleming JE, Hawley LL, Ho MH, Antony MM. Mindfulness and acceptancebased group therapy and traditi onal cogniti ve behavioral group therapy for social anxiety disorder: mechanisms of change. Behav Res Ther. 2015;70:11-22.

Kristeller JL, Wolever RQ. Mindfulness-based eati ng awareness training for treati ng binge eati ng disorder: the conceptual foundati on. Eat Disord. 2011;19:49-61.

Ong JC, Shapiro SL, Manber R. Combining mindfulness meditati on with cogniti ve-behavior therapy for insomnia: a treatment-development study. Behav Ther. 2008;39:171-82.

Ong J, Sholtes D. A mindfulness-based approach to the treatment of insomnia. J Clin Psychol. 2010;66:1175-84.

Ong JC, Manber R, Segal Z, Xia Y, Shapiro S, Wyatt JK. A randomized controlled trial of mindfulness meditati on for chronic insomnia. Sleep. 2014;37:1553-63.

Black DS, O’Reilly GA, Olmstead R, Breen EC, Irwin MR. Mindfulness meditati on and improvement in sleep quality and dayti me impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Intern Med. 2015;175:494-501.

Zhang JX, Liu XH, Xie XH, Zhao D, Shan MS, Zhang XL, et al. Mindfulness-based stress reducti on for chronic insomnia in adults older than 75 years: a randomized, controlled, single-blind clinical trial. Explore (NY). 2015;11:180-5.

Britt on WB, Haynes PL, Fridel KW, Bootzin RR. Mindfulness-based cogniti ve therapy improves polysomnographic and subjecti ve sleep profi les in anti depressant users with sleep complaints. Psychother Psychosom. 2012;81:296-304.

Okajima I, Nakajima S, Ochi M, Inoue Y. Reducing dysfuncti onal beliefs about sleep does not signifi cantly improve insomnia in cogniti ve behavioral therapy. PLoS One. 2014;9:e102565.

Sánchez-Ortuño MM, Edinger JD. Internight sleep variability: its clinical signifi cance and responsiveness to treatment in primary and comorbid insomnia. J Sleep Res. 2012;21:527-34.

Downloads

Publicado

2015-10-30

Como Citar

1.
Margis R. Terapia cognitivo-comportamental na insônia. Debates em Psiquiatria [Internet]. 30º de outubro de 2015 [citado 7º de novembro de 2024];5(5):22-7. Disponível em: https://revistardp.org.br/revista/article/view/158

Edição

Seção

Artigos de Atualização

Plaudit