본 연구는 불면증 인지행동치료(Cognitive Behavioral Therapy of Insomnia: CBT-I)의 효과를 생리심리학적 관점에서 규명하기 위해 시행되었다. 연구대상은 다른 정신과적 장애나 수면무호홉증, 일주기리듬 수면장애를 충족하지 않으며 수면의 어려움을 시사하는 불면증 심각도 척도(Insomnia Severity index: ISI) 점수가 15점 이상, 수면의 질(Pittsburgh Sleep Quality Index: PSQI)점수가 6점 이상을 나타낸 참가자들이며, 이들을 치료집단과 대기통제집단에 무선할당 하였다. 8명의 치료집단은 6회기의 불면증 인지행동치료를 받았고, 9명의 대기통제집단은 6주간 아무런 처지를 받지 않았다. CBT-I의 효과검증을 위해 치료집단과 대기통제집단의 치료 전과 후에 휴식기 정량적 뇌파, 심박변이도를 측정하였고, 수면 관련 자기보고 척도를 실시하였으며, 스마트 웨어러블 기기 및 수면일지 작성을 통해 수면 양상을 파악하였다. 연구 결과, 치료집단은 대기통제집단보다 고주파 대역인 Beta 주파수 대역의 파워감소, 수면 관련 자기보고 척도 점수의 감소, 수면 효율성과 수면만족도가 증가하였음을 확인하였다. 본 연구는 불면증 인지행동치료의 효과를 신경생리학적 과각성 지표인 고주파 대역의 파워 감소를 통해 확인하였고, 기존의 불면증 인지행동치료 효과 검증에서 사용되는 자기보고식 측정 뿐 만 아니라, 객관적 자료인 스마트 웨어러블 기기의 수면 정보를 활용하였다는 점에서 의의가 있다.
This study demonstrated the physiological and psychological effects of Cognitive Behavioral Therapy for Insomnia (CBT-I). CBT-I is an evidence-based psychotherapy that deals with bad sleep habits and behaviors, dysfunctional beliefs, and attitudes toward sleep. In this study, participants who did not have other mental illnesses or sleep problem related to sleep apnea of circadian rhythm sleep disorder and showed an insomnia severity index of 15 or more and Pittsburgh sleep quality index of 6 or more were recruited. They were randomly assigned to a treatment or a wait-list control group. The treatment group received six 60-min sessions of CBT-I (n=8), while the wait-list control group received not any psychological intervention(n=9). To verify the effectiveness of CBT-I, we measured the resting quantitative EEG and heart rate variability, insomnia symptom by self-report sleep scale and sleep monitoring data by smart wearable devices and sleep diary before and after treatment Results showed significantly decreased Beta power, sleep scale score and increased Theta power, WASO(Wake After Sleep Onset), SE(Sleep Efficiency), Sleep satisfaction. This study found that daytime hyperactivity can be reduced by psychological intervention. In addition, it is significant thatl the improvement of sleep problem were observed by using not only subjective self-report but also objective measures such as resting quantitative EEG and smart wearable devices.
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