ABSTRACT

Introduction

Depression and anxiety are prevalent mental health conditions in older adulthood. Despite sleep disturbance being a common comorbidity in late-life depression and anxiety, it is often discounted as a target for treatment. The current review aims to establish whether cognitive-behavioral therapy (CBT) is effective in treating concomitant sleep disturbance in depressed and anxious older adults and to review evidence supporting whether CBT interventions targeting anxiety and depression, or concurrent sleep disturbance, have the greatest effectiveness in this client group.

Method

A systematic database search was conducted to identify primary research papers evaluating the effectiveness of CBT interventions, recruiting older adults with symptoms of depression and/or anxiety, and employing a validated measure of sleep disturbance. The identified papers were included in a narrative synthesis of the literature.

Results

Eleven identified studies consistently support reductions in sleep disturbance in elderly participants with depression and anxiety in response to CBT. Most CBT interventions in the review included techniques specifically targeting sleep, and only one study directly compared CBT for insomnia (CBT-I) with a CBT-I intervention also targeting depressive symptoms, limiting the ability of the review to comment on whether interventions targeting sleep disturbance or mental health symptoms have superior effectiveness.

Conclusion

The extant research indicates that CBT interventions are effective in ameliorating sleep disturbance in late-life depression and anxiety. Future high-quality research is required to substantiate this finding and to compare the effectiveness of CBT-I and CBT for depression and anxiety in this group to inform clinical practice.

中文翻译：

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认知行为干预对抑郁和焦虑社区居住老年人睡眠障碍的影响：系统评价

摘要

介绍

抑郁和焦虑是老年人普遍存在的心理健康状况。尽管睡眠障碍是晚年抑郁症和焦虑症的常见合并症，但它通常被低估为治疗的目标。本综述旨在确定认知行为疗法 (CBT) 是否能有效治疗抑郁和焦虑的老年人伴随的睡眠障碍，并审查支持针对焦虑和抑郁或并发睡眠障碍的 CBT 干预是否在以下方面最有效的证据。这个客户群。

方法

进行了系统的数据库搜索，以确定评估 CBT 干预效果的主要研究论文，招募有抑郁和/或焦虑症状的老年人，并采用经过验证的睡眠障碍测量。确定的论文包含在文献的叙述性综合中。

结果

11 项确定的研究一致支持减少患有抑郁和焦虑的老年参与者对 CBT 的睡眠障碍。评价中的大多数 CBT 干预包括专门针对睡眠的技术，只有一项研究直接比较了针对失眠的 CBT (CBT-I) 与同样针对抑郁症状的 CBT-I 干预，限制了评价评论是否针对睡眠的干预的能力干扰或心理健康症状具有更高的有效性。

结论

现有研究表明，CBT 干预可有效改善晚年抑郁症和焦虑症的睡眠障碍。未来需要高质量的研究来证实这一发现，并比较 CBT-I 和 CBT 治疗该组抑郁症和焦虑症的有效性，从而为临床实践提供信息。