Terapia non farmacologica dell’insonnia: igiene del sonno e restrizione a confronto

Contenuto principale articolo

Alessandro Cicolin
Alessandra Giordano

Abstract

Introduzione


L’insonnia è il più comune di tutti i disturbi del sonno interessando nel corso della vita più del 40% della popolazione. La prima scelta terapeutica è di tipo non farmacologico ed è costituita dalla terapia cognitivo-comportamentale (TCC).


Negli anni, è stata studiata l’efficacia della restrizione del sonno e delle regole di igiene del sonno, considerate sia singolarmente sia come parte di un programma più completo.


Obiettivo


Valutare e comparare l’efficacia delle tecniche di restrizione del sonno e igiene del sonno nel trattamento dell’insonnia cronica anche in relazione alla qualità di vita.


Materiali e metodi


L’efficacia terapeutica è stata valutata mediante actigrafia e diario del sonno, la qualità della vita è stata auto-valutata mediante somministrazione del questionario Short Form Health Survey (SF-36).


Risultati


Venti soggetti hanno completato lo studio. Nel gruppo restrizione di sonno, sono state evidenziate differenze statisticamente significative (p<0.05) rispetto a T0, per quanto riguarda il tempo trascorso a letto (TIB) e la veglia infrasonno (WASO), che diminuiscono, e l’efficienza di sonno (SE), che aumenta.


All’SF36, aumenta la percezione di una migliore salute in generale.


Nel gruppo trattamento con igiene del sonno non si evidenziano, dopo trattamento, significative variazioni di TST, TIB, WASO e SE rispetto a T0 mentre all’SF-36 aumentano i punteggi alle sotto scale relative al concetto di salute in generale, al funzionamento fisico, al dolore e alla percezione di salute mentale.


Discussione


Il gruppo restrizione del sonno sembra migliorare maggiormente su parametri oggettivi actigrafici, seppur in presenza di un moderato tasso di drop-out, mentre il gruppo igiene del sonno attraverso alcuni parametri soggettivi relativi alla qualità della vita.


Conclusioni


Lo studio evidenzia come entrambe le tecniche siano efficaci nel miglioramento del sonno in soggetti insonni, benché su aspetti differenti.


Parole chiave


Insonnia, igiene del sonno, restrizione del sonno

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