慢性失眠患者於生理回饋治療之成效初探

A Preliminary Study of the Effects of Biofeedback for Chronic Insomnia

目的：由文獻得知，睡前的身心激發是影響失眠的重要因素，長期失眠更影響自我效能，而生理回饋治療具有降低睡前的身心激發水準及提升自我效能功效，本研究目的在瞭解慢性失眠患者接受生理回饋治療後，其失眠問題改善情形。方法：本研究採前後測類實驗設計，將慢性失眠者分為生理回饋組、放鬆組及控制組三組，分別在治療前、後、及治療結束後6週三階段，以睡眠相關變項及自我效能等標準化問卷評量，進行repeared-measured ANOVA統計分析，以了解生理回饋對慢性失眠患者之介入成效。結果：本研究發現在治療結束後，生理回饋與放鬆治療兩組在睡眠預測力、睡眠品質、失眠困擾、及失眠嚴重度有顯著改善；於追蹤階段，兩組之改善成效維持，且生理回饋組更優於放鬆組。結論：生理回饋治療能有效降低慢性失眠患者身心激發水準， 且對睡眠的預測力及睡眠品質提昇，主觀的失眠嚴重度與失眠困擾下降具顯著改善。

Objectives. According to previous studies, psycho-physiological arousals before sleep are important factors that influence insomnia, and long-term insomnia has serious effects on self-efficacy. Biofeedback therapy helps decrease physical, emotional, and cognitive arousals before sleep, improving sleep and increasing self-efficacy. Goals are often set to help clients with chronic insomnia recognize progress in improvement. In this preliminary study, we tested the effect of a two treatment group (relaxation and biofeedback) against a control group on insomnia. Methods. A quasi-experimental pretest-posttest research design was used. The sample of chronic insomnia clients were assigned to the relax group, the biofeedback group, and the control group. The standardized questionnaires were administered before and after the treatment, as well as one 6-week sequential follow-up, Statistical analysis using repeatedmeasured ANOVA, was performed to test results. Results. After the treatment course, the biofeedback group and relax group had more significant improvements than the control group on sleeping predicting ability, subjective sleep quality, insomnia torments, and insomnia severity. The effects of the two intervention groups on the follow-up period could be maintained significantly. The effects of the biofeedback on these outcomes were even better than those using relax techniques. Conclusion. The biofeedback therapy decreased the emotional and cognitive arousals of patients with chronic insomnia. The most noticeable therapeutic effects client perceived improvements in sleeping predictability and sleep quality and decreases in subjective insomnia severity and insomnia torments.