Terapia cognitivo-comportamental para insônia: revisão sistemática
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Data
2015-03-31
Autores
Teixeira, Camila de Masi [UNIFESP]
Orientadores
Carvalho, Luciane Bizari Coin de [UNIFESP]
Tipo
Dissertação de mestrado
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Resumo
A Terapia Cognitivo-Comportamental (TCC) tem sido amplamente utilizada na prática clínica, e avaliada em ensaios clínicos e revisões sistemáticas, embora não existam protocolos bem definidos sobre o emprego das técnicas e sobre os desfechos que devem ser mensurados. Objetivo: o objetivo desta revisão sistemática foi avaliar a aplicação da TCC para adultos insones, comparada a quatro grupos de controle (lista de espera, sem tratamento, intervenção farmacológica e outras intervenções não farmacológicas), realizada em intervalo de quatro a oito semanas, utilizando as técnicas de Controle de Estímulos, Restrição de Sono, Reestruturação Cognitiva e Técnicas de Relaxamento. Materiais e métodos: as estratégias de busca foram submetidas às bases de dados MEDLINE (1966 a agosto de 2014), EMBASE (1980 a agosto de 2014), LILACS (1982 a agosto de 2014), Cochrane Central Register of Controlled Trials ? CENTRAL (agosto de 2014), PsycINFO (agosto de 2014) e WHO (agosto de 2014). Não houve restrição sobre a maneira de aplicação da TCC, e os resultados foram avaliados separadamente, quando necessário. Resultados: seis ensaios clínicos randomizados foram incluídos. A TCC apresentou melhora na qualidade de vida e na performance diurna, diminuiu os sintomas subjetivos da insônia e aumentou a eficiência do sono. Conclusão: embora os resultados demonstrem efetividade da TCC, investigações posteriores são necessárias. Muitos resultados foram avaliados a partir da análise de um único estudo e a qualidade da evidência foi considerada como muito baixa.
Cognitive Behavioural Therapy (CBT) for insomnia has been used in clinical practice and evaluated in clinical trials and systematic reviews, although there are no set protocols for how the technique should be applied and results measured. Objectives: The aim of this systematic review was to evaluate the application of CBT, incorporating the techniques of stimulus control, sleep restriction, cognitive restructuring, and relaxation techniques, when performed between 4 and 8 weeks for insomnia in adults compared to four different control groups: waitlist, no treatment, pharmacological intervention, and other non-pharmacological interventions. Methods: The search strategies were found in MEDLINE (1966 to August 2014), EMBASE (1980 to August 2014), LILACS (1982 to August 2014), Cochrane Central Register of Controlled trials ¬- CENTRAL (August 2014), PsycINFO (data August 2014), and WHO (August 2014). There were no restrictions as to the manner of application of CBT, and the results were evaluated separately. Results: Six randomized controlled trials were included. CBT improved quality of life and daytime performance, reduced subjective symptoms of insomnia, and increased sleep efficiency. Conclusions: Although the results demonstrate effectiveness for CBT, further investigations are necessary, because most results were evaluated in terms of only one publication and the quality of evidence was considered very low.
Cognitive Behavioural Therapy (CBT) for insomnia has been used in clinical practice and evaluated in clinical trials and systematic reviews, although there are no set protocols for how the technique should be applied and results measured. Objectives: The aim of this systematic review was to evaluate the application of CBT, incorporating the techniques of stimulus control, sleep restriction, cognitive restructuring, and relaxation techniques, when performed between 4 and 8 weeks for insomnia in adults compared to four different control groups: waitlist, no treatment, pharmacological intervention, and other non-pharmacological interventions. Methods: The search strategies were found in MEDLINE (1966 to August 2014), EMBASE (1980 to August 2014), LILACS (1982 to August 2014), Cochrane Central Register of Controlled trials ¬- CENTRAL (August 2014), PsycINFO (data August 2014), and WHO (August 2014). There were no restrictions as to the manner of application of CBT, and the results were evaluated separately. Results: Six randomized controlled trials were included. CBT improved quality of life and daytime performance, reduced subjective symptoms of insomnia, and increased sleep efficiency. Conclusions: Although the results demonstrate effectiveness for CBT, further investigations are necessary, because most results were evaluated in terms of only one publication and the quality of evidence was considered very low.
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Citação
TEIXEIRA, Camila De Masi. Terapia cognitivo-comportamental para insônia: revisão sistemática. 2015. 153 f. Dissertação (Mestrado em Medicina Translacional) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2015.