PTSD-related hyperarousal assessed during sleep
PTSD-related hyperarousal assessed during sleep
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DOI：
10.1016/s0031-9384(00)00271-7
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发表时间：
2000-07-01
影响因子：
2.9
通讯作者：
Bliwise, DL
中科院分区：
文献类型：
--
作者：
Woodward, SH;Murburg, MM;Bliwise, DL
创伤后应激障碍被广泛理解为包括“觉醒增强的持续症状”。这种假设很少在可以排除预期焦虑影响的情况下得到检验。在这项研究中，在睡眠状态下，心率和脑电图频谱功率被评估，这是一种没有大多数人造源污染紧张性觉醒指数的状态。56名患有创伤后应激障碍（PTSD）的未服药的非窒息性越南战争住院患者和14名对照者在睡眠实验室度过了3个或更多的夜晚，在此期间，他们的心电图和脑电图被连续记录下来。心率和脑电图频谱功率连续离线量化，并在所有适应后的夜晚按睡眠阶段平均。PTSD患者报告的睡眠心率无组间差异，且与主观亢奋程度无共变。PTSD患者在非快速眼动（NREM）睡眠中表现出低频脑电图频谱功率降低的趋势。在那些产生可记分的慢波睡眠的受试者中，这种减少在慢波睡眠期间是显著的。PTSD患者和对照组的快速眼动(REM) β -频带功率与非快速眼动(NREM) β -频带功率的关系不同，患者在快速眼动和非快速眼动睡眠中β -频带功率高于对照组。非快速眼动期睡眠西格玛带脑电图频谱功率与主观高觉醒呈正相关。最后，仅在PTSD患者中观察到快速眼动-非快速眼动睡眠心率差异与快速眼动睡眠百分比之间的新颖且令人惊讶的强烈负相关。综上所述，睡眠期间外周和中枢的紧张性觉醒测量显示出与PTSD诊断和症状状态的对比关系。数据表明，应该更多地考虑创伤后应激障碍的中枢唤醒机制。(C) 2000 Elsevier Science Inc.；版权所有。
Posttraumatic stress disorder is widely understood to include "persistent symptoms of increased arousal." This presumption has rarely been tested under conditions in which effects of anticipatory anxiety could be ruled out. Zn this study, heart rate and electroencephalogram spectral power were assessed during sleep, a state free of most sources of artifact contaminating indices of tonic arousal. Fifty-six unmedicated nonapneic Vietnam combat-related inpatients with posttraumatic stress disorder (PTSD) and 14 controls spent 3 or more nights in the sleep laboratory during which their electrocardiograms and electroencephalograms were continuously recorded. Heart rate and electroencephalogram spectral power were quantified continuously off-line and averaged by sleep stage over all postadaptational nights. Sleep heart rate exhibited no group differences and no covariation with the severity of subjective hyperarousal reported by PTSD patients. PTSD patients exhibited a trend toward reduced low-frequency electroencephalogram spectral power during nonrapid-eye-movement (NREM) sleep. This reduction was significant during slow-wave sleep in those subjects producing scoreable slow-wave sleep. The relationship of rapid-eye-movement (REM) beta-band power to NREM beta-band power was different in PTSD patients and controls, with the patients exhibiting more beta in REM versus NREM sleep than controls. In patients, NREM sleep sigma-band electroencephalogram spectral power exhibited a positive correlation with subjective hyperarousal. Finally, a novel and surprisingly strong inverse correlation between REM-NREM sleep heart rate difference and REM percent of sleep was observed in PTSD patients only. In summary, peripheral and central measures of tonic arousal during sleep demonstrated contrastive relations to PTSD diagnostic and symptom status. The data suggest that more consideration should be directed to mechanisms of central arousal in PTSD. (C) 2000 Elsevier Science Inc. All rights reserved.