OBJECTIVE This randomized comparative effectiveness trial evaluated a novel insomnia treatment using acceptance and commitment therapy (ACT) among women veterans. Participants received either the acceptance and the behavioral changes to treat insomnia (ABC-I) or cognitive behavioral therapy for insomnia (CBT-I). The primary objectives were to determine whether ABC-I was noninferior to CBT-I in improving sleep and to test whether ABC-I resulted in higher treatment completion and adherence versus CBT-I. METHOD One hundred forty-nine women veterans with insomnia disorder (Mage = 48.0 years) received ABC-I or CBT-I. The main sleep outcomes were Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and sleep efficiency (SE) by actigraphy (objective) and sleep diary (subjective). Measures were collected at baseline, immediate posttreatment, and 3-month posttreatment follow-up. Treatment completion and adherence were assessed during the interventions. RESULTS Both interventions improved all sleep outcomes from baseline to immediate posttreatment and 3-month posttreatment follow-up. At immediate posttreatment, ABC-I was statically noninferior for sleep diary SE and objective SE, but noninferiority was not statistically confirmed for ISI or PSQI total scores. At 3-month posttreatment follow-up, ABC-I was noninferior for all four of the key outcome variables. There was not a statistically significant difference between the number of participants who discontinued CBT-I (11%) versus ABC-I (18%; p = .248) before completing treatment. ABC-I was superior to CBT-I for some adherence metrics. CONCLUSIONS Overall, ABC-I was similar in effectiveness compared to CBT-I for the treatment of insomnia and may improve adherence to some behavioral elements of treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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基于接受和承诺疗法与认知行为疗法治疗失眠的新疗法：一项针对女性退伍军人的随机比较有效性试验。

目的 这项随机比较有效性试验评估了一种在女性退伍军人中使用接受和承诺疗法 (ACT) 的新型失眠疗法。参与者接受了治疗失眠的接受和行为改变（ABC-I）或失眠的认知行为疗法（CBT-I）。主要目标是确定 ABC-I 在改善睡眠方面是否不劣于 CBT-I，并测试 ABC-I 是否比 CBT-I 导致更高的治疗完成度和依从性。方法 149 名患有失眠症的女性退伍军人（Mage = 48.0 岁）接受了 ABC-I 或 CBT-I。主要睡眠结果是失眠严重程度指数（ISI）、匹兹堡睡眠质量指数（PSQI）以及通过体动记录仪（客观）和睡眠日记（主观）得出的睡眠效率（SE）。在基线、治疗后立即和治疗后 3 个月随访时收集测量结果。在干预期间评估治疗完成情况和依从性。结果 两种干预措施均改善了从基线到治疗后立即和治疗后 3 个月随访的所有睡眠结果。治疗后立即，ABC-I 在睡眠日记 SE 和客观 SE 方面静态非劣效，但 ISI 或 PSQI 总分的非劣效性并未得到统计学证实。在治疗后 3 个月的随访中，ABC-I 在所有四个关键结果变量上均不较差。在完成治疗之前停止 CBT-I (11%) 与 ABC-I (18%; p = .248) 的参与者数量之间没有统计学上的显着差异。在某些依从性指标上，ABC-I 优于 CBT-I。结论 总体而言，ABC-I 与 CBT-I 治疗失眠的效果相似，并且可以提高对治疗某些行为要素的依从性。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。