An analysis on the differences in therapeutic effects of cognitive behavioral therapy for insomnia in chronic insomnia disorder patients with different personality traits

FENG Xia; WANG Ying; FANG Chao; SHANG Yuanhao; WANG Ziyun; HU Jin

doi:10.3969/j.issn.1674-3806.2024.11.12

Abstract：Objective To explore the differences in therapeutic effects of cognitive behavioral therapy for insomnia (CBTI) in chronic insomnia disorder patients with different personality traits.Methods Sixty patients with chronic insomnia disorder who were admitted to the Second People's Hospital of Guizhou Province from January 2018 to August 2021 were recruited.According to the results of the Eysenck Personality Questionnaire(EPQ) revised by Gong Yaoxian,the patients were divided into neuroticism group,extraversion group and psychoticism group,with 20 cases in each group.All the three groups received CBTI for 8 weeks.Sleep diaries were used to assess the changes in subjective and objective sleep quality indicators in the patients of the three groups before treatment(T0),at the end of treatment(T1),and three months after the end of treatment(T2).The relevant indicators of polysomnography(PSG) and serum cortisol levels were compared among the three groups at the time points of T0 and T1.Results According to the sleep diaries,sleep latency(SL),wake after sleep onset(WASO),sleep efficiency(SE) and total sleep time(TST) in the neuroticism group after treatment did not change significantly compared with those before treatment(P＞0.05).After treatment,SL and WASO gradually decreased,while SE and TST gradually increased in the extraversion group and the psychoticism group,and there were significant differences compared with those at the time point of T0 (P＜0.05).Compared with the neuroticism group,the extraversion group and the psychoticism group had shorter ST,longer TST and higher SE at T1 and T2 time points,and the differences were statistically significant(P＜0.05).However,there was no statistically significant difference in each indicator between the extraversion group and the psychoticism group(P＞0.05).According to the PSG results,there was no significant difference in the change of each indicator in the neuroticism group before and after treatment(P＞0.05).In the extraversion group,compared with those at the time point of T0,WASO and the proportion of N2 stage decreased,while SE and the proportion of N3 stage,TST and the proportion of rapid eye movement(REM) stage increased significantly at the time point of T1(P＜0.05).In the psychoticism group,comopared with those at the time point of T0,TST,SE and the proportion of N3 stage increased,and WASO decreased at the time point of T1,and the differences were statistically significant(P＜0.05).The results of inter-group comparison showed that there were no statistically significant differences in SL,WASO,TST,SE,and proportions of N1 stage,N2 stage and N3 stage among the three groups at the time point of T0(P＞0.05).At the time point of T1,compared with the neuroticism group,the extraversion group had a decrease in the proportion of N2 stage and an increase in the proportion of REM,and compared with the neuroticism group,the psychoticism group had decreases in WASO and the proportion of N2 stage and increases in SE and the proportion of N3 stage,and the differences were significant(P＜0.05).Compared with that at the time point of T0,the serum cortisol level in the neuroticism group increased while the serum cortisol level in the psychoticism group decreased at the time point of T1,and the differences were significant(P＜0.05),but the serum cortisol level of the extraversion group after treatment did not change significantly compared with that before treatment(P＞0.05).The results of inter-group comparison showed that the serum cortisol levels in the three groups did not change significantly compared with those before treatment(P＞0.05).Conclusion There are significant differences in therapeutic effects of CBTI in chronic insomnia disorder patients with different personality traits.The effects of CBTI in the insomnia patients with psychopathic personality and extraverted personality are better,but the effect of CBTI in the insomnia patients with neurotic personality is unsatisfactory.