Sleep in lifetime posttraumatic stress disorder - A community-based polysomnographic study
Sleep in lifetime posttraumatic stress disorder - A community-based polysomnographic study
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DOI：
10.1001/archpsyc.61.5.508
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发表时间：
2004-05-01
影响因子：
--
通讯作者：
Roehrs, T
中科院分区：
文献类型：
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作者：
Breslau, N;Roth, T;Roehrs, T
背景：睡眠障碍在创伤后应激障碍（PTSD）中很常见，并被列入DSM标准。对特定创伤受试者的小样本进行的多导睡眠图研究得出了相互矛盾的结果。因此，我们评估了多导睡眠障碍PTSD.Methods：一个有代表性的队列的成年社区居民随访10年的创伤和PTSD暴露选择一个子集的睡眠研究连续2晚和中间的一天。受试者选自一家大型健康维护组织，除社会经济地位范围的极端情况外，均代表该地理区域。睡眠研究的子集选自队列的10年随访（n=913 [初始样本的91%]）。资格标准包括：（1）在过去5年内遭受创伤的受试者;（2）其他符合创伤后应激障碍标准的人;（3）随机预选的子样本。在439名合格的受试者中，292名（66.5%）参与了研究，其中71名患有终生PTSD。主要结果包括睡眠诱导，维护，分期和碎片的标准多导睡眠测量;呼吸暂停/呼吸不足和周期性腿部运动的标准措施;和多次睡眠潜伏期test.Results的结果：在睡眠障碍的标准措施，PTSD受试者和对照组受试者之间检测没有差异，无论在对照组的创伤或抑郁症的历史。患有PTSD的人在快速眼动睡眠（REM）中有更高的短暂觉醒率。向浅睡眠和觉醒的转变是REM特有的，并且在REM和非REM睡眠之间存在显著差异（F-1，F-278=5.92; P= 0.02）。结论：我们没有发现PTSD患者临床相关睡眠障碍的客观证据。在PTSD受试者中检测到快速眼动睡眠的短暂觉醒次数增加。PTSD患者的睡眠问题可能代表了快速眼动睡眠中短暂觉醒的放大感知。
Background: Sleep complaints are common in post-traumatic stress disorder (PTSD) and are included in the DSM criteria. Polysomnographic studies conducted on small samples of subjects with specific traumas have yielded conflicting results. We therefore evaluated polysomnographic sleep disturbances in PTSD.Methods: A representative cohort of young-adult community residents followed-up for 10 years for exposure to trauma and PTSD was used to select a subset for sleep studies for 2 consecutive nights and the intermediate day. Subjects were selected from a large health maintenance organization and are representative of the geographic area except for the extremes of the socioeconomic status range. The subset for the sleep study was selected from the 10-year follow-up of the cohort (n=913 [91% of the initial sample]). Eligibility criteria included (1) subjects exposed to trauma during the preceding 5 years; (2) others who met PTSD criteria; and (3) a randomly preselected subsample. Of 439 eligible subjects, 292 (66.5%) participated, including 71 with lifetime PTSD. Main outcomes included standard polysomnographic measures of sleep induction, maintenance, staging, and fragmentation; standard measures of apnea/hypopnea and periodic leg movement; and results of the multiple sleep latency test.Results: On standard measures of sleep disturbance, no differences were detected between subjects with PTSD and control subjects, regardless of history of trauma or major depression in the controls. Persons with PTSD had higher rates of brief arousals from rapid eye movement (REM) sleep. Shifts to lighter sleep and wake were specific to REM and were significantly different between REM and non-REM sleep (F-1,F-278=5.92; P=.02).Conclusions: We found no objective evidence for clinically relevant sleep disturbances in PTSD. An increased number of brief arousals from REM sleep was detected in subjects with PTSD. Sleep complaints in PTSD might represent amplified perceptions of brief arousals from REM sleep.