Abstract：Objective To explore the effects of cognitive behavioral therapy for insomnia(CBT-I)on generalized anxiety disorder with insomnia.Methods Thirty six patients with generalized anxiety disorder and insomnia were recruited by advertisements posted at the hospital from September 2014 to September 2016.The patients were divided into therapy group and control group by random number table method,with 18 cases in each group.The patient received escitalopram treatment(P.O.,10 mg/d).The patients in the therapy group were treated by CBT-I,and the patients in the control group were educated with knowledge related to insomnia.The clinical effects were compared between the two groups.Results Sixteen patients in the therapy group and seventeen patients in the control group completed the study.After the CBT-I treatment,the Insomnia Severity Index scores and the Hamilton Anxiety Scale scores of the therapy group were both significantly lower than those of the control group,the differences were statistically significant(P＜0.05).The sleep efficiency and the percentage of deep sleep time of the therapy group were both significantly higher than those of the control group， the differences were statistically significant(P＜0.05).The HAMA scores of the therapy group was significantly lower than that of the control group,the differences were statistically significant (P＜0.05).Conclusion CBT-I can not only significantly improve the symptoms of insomnia,but also relieve the anxiety symptoms in patients with generalized anxiety disorders.
Thomas Roth.Comorbid insomnia：current directions and future challenges[J].Am J Manag Care，2013，15（3）：S6-S13.
[3]
Sanchez-Ortuno MM，Edinger JD.Cognitive-Behavior Therapy for the management of insomnia comorbid with mental disorders[J].Curr Psychiatry Rep，2015，14（5）：519-528.
[4]
Genevieve B，Heloise C，Katia L，et al.Meta-analytic review of the impact of cognitive-behavior therapy for insomnia on concomitant anxiety[J].Clin Psychol Rev，2015，31（4）：638-652.
[5]
Borge S，Siri O，Stale P，et al.Cognitive behavioral therapy vs zopiclone for treatment of chronic primary insomnia in older adults[J].JAMA，2012，295（24）：2851-2858.
[7]
Robert HH.Managing common side effects of SSRIs[J].J Psychosocial Nursing，2001，234（45）：15-18.
[8]
Michael LP，Carla J，Michael TS，et al. 失眠的认知行为治疗：逐次晤谈指南[M].北京：人民卫生出版社，2012.
[11]
美国睡眠医学会.睡眠及其相关事件判读手册[M].北京：人民军医出版社，2006.
[6]
World Health Organ ization.The ICD-10 classification of mental and behavioral disorders：clinical descriptions and diagnostic guidelines[M].Geneva： World Health Organization，1992.
[9]
Rachel M，Jack DE，Jenna LG，et al.Cognitive behavioral therapy for insomnia enhances depression outcome in patients with comorbid major depressive disorder and insomnia[J].Sleep，2014，31（4）：489-495.
[10]
Morin CM，Belleville G，Belanger，et al.The insomnia severity index：psychometric indicators to detect insomnia cases and evaluate treatment response[J].Sleep，2011，34（5）：601-608.
[12]
Manber R，Buysse DJ，Edinger J，et al.Efficacy of therapy for insomnia combined with antidepressant pharmacotherapy in patients with comorbid depression and insomnia：a randomized controlled trail[J].J Clin Psychiatry，2016，77（10）：1316-1323.
[13]
Pchelina PV，Tabidze AA，Poluektov MG.Compara tive study of effectiveness of cognitive-behavior therapy and zopiclone for chronic insomnia[J].Zh Nevrol Psikhiatr Im S S Korsakova，2017，117（4）：48-55.
[14]
Belleville G，Cousineau H，Levrier K，et al.Meta-analytic review of the impact of cognitive-behavior therapy for insomnia on concomitant anxiety[J].Clin Psychol Rev，2011，31（4）：638-652.
[15]
YeY，ZhangY，ChenJ，etal.Internet-basedcognitivebehavioral therapy for insomnia （ICBT-i） improves co-morbid anxiety and depression—a meta-analysis of randomized controlled trials[J].PLoS One，2015，10（11）：2254-2258.
[16]
MyersE，StartupH，FreemanD.Cognitivebehaviouraltreatment of insomnia in individuals with persistent persecutory delusions：a pilot trial[J].Behav Ther Exp Psychiatry，2016，42（3）：330-336.
[17]
Barry K，Lisa J，Dominic M，et al.An open-label trial of evidence-based cognitive behavior therapy for nightmares andinsomniaincrimevictimsWithPTSD[J].AmJ Psychiatry，2011，158（12）：2043-2047.
[18]
Anne G，Katherine S，Martica H，et al.Effects of a brief behavioral treatment for PTSD-related sleep disturbance：a pilot study[J].Behaviour Res Ther，2013，45（3）：627-632.
[19]
Talbot LS，Maguen S，Metzler TJ，et al.Cognitive behavioral therapy for insomnia in posttraumatic stress disorder：a randomized controlled trial[J].Sleep，2015，37（2）：327-341.
[20]
Margolies SO，Rybarczyk B，Vrana SR，et al.Efficacy of a cognitive-behavioral treatment for insomnia and nightmares inAfghanistanandIraqveteranswith PTSD[J].J Clin Psychol，2016，69（10）：1026-1042.
[21]
Thorndike FP，Ritterband LM，Gonder-Frederick，et al.A randomized controlled trial of an internet intervention for adults with insomnia：effects on comorbid psychological and fatigue symptoms[J].J Clin Psychol，2015，69（10）：1078-1093.
[22]
Markus JF，Annika NC.Cognitive behavioural therapy for insomnia in psychiatric disorders[J].Curr Sleep Med Rep，2016，2（4）：233-240.
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