Sleep and REM sleep disturbance in the pathophysiology of PTSD: the role of extinction memory.
Sleep and REM sleep disturbance in the pathophysiology of PTSD: the role of extinction memory.
复制标题
DOI：
10.1186/s13587-015-0018-9
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Milad MR
中科院分区：
文献类型：
--
作者：
Pace-Schott EF;Germain A;Milad MR
创伤后应激障碍（PTSD）伴随着睡眠障碍和学习和记住条件恐惧的灭绝能力受损。发生创伤事件后，全部PTSD症状通常需要几个月的发展。在此期间，睡眠障碍（例如失眠症，噩梦和零散的快速眼动睡眠睡眠）可以预测PTSD症状的后期发展。只有少数接触创伤的人继续发展PTSD。我们假设是由于急性创伤或创伤经历所引起的睡眠障碍可能有助于PTSD的病因。由于症状会随着时间的流逝而恶化，因此我们建议持续的睡眠障碍也可以维持和加剧PTSD。睡眠障碍可能导致灭绝记忆无法持续和概括，我们建议这构成一种非排他性的机制，通过这种机制，睡眠不良有助于PTSD的发展和永久性。还综述的是神经内分泌系统，这些系统显示出PTSD异常，其中压力反应和睡眠干扰可能会产生协同作用，从而干扰灭绝的学习和记忆。还讨论了一些初步证据表明，仅凭失眠可能会破坏与睡眠有关的情绪过程，包括灭绝记忆的巩固。我们建议，在暴露疗法期间，在创伤后优化睡眠质量，甚至从策略性地安排睡眠以加强灭绝记忆，可以使睡眠本身可以在治疗PTSD和其他创伤和与压力有关的疾病的治疗中招募。
Post-traumatic stress disorder (PTSD) is accompanied by disturbed sleep and an impaired ability to learn and remember extinction of conditioned fear. Following a traumatic event, the full spectrum of PTSD symptoms typically requires several months to develop. During this time, sleep disturbances such as insomnia, nightmares, and fragmented rapid eye movement sleep predict later development of PTSD symptoms. Only a minority of individuals exposed to trauma go on to develop PTSD. We hypothesize that sleep disturbance resulting from an acute trauma, or predating the traumatic experience, may contribute to the etiology of PTSD. Because symptoms can worsen over time, we suggest that continued sleep disturbances can also maintain and exacerbate PTSD. Sleep disturbance may result in failure of extinction memory to persist and generalize, and we suggest that this constitutes one, non-exclusive mechanism by which poor sleep contributes to the development and perpetuation of PTSD. Also reviewed are neuroendocrine systems that show abnormalities in PTSD, and in which stress responses and sleep disturbance potentially produce synergistic effects that interfere with extinction learning and memory. Preliminary evidence that insomnia alone can disrupt sleep-dependent emotional processes including consolidation of extinction memory is also discussed. We suggest that optimizing sleep quality following trauma, and even strategically timing sleep to strengthen extinction memories therapeutically instantiated during exposure therapy, may allow sleep itself to be recruited in the treatment of PTSD and other trauma and stress-related disorders.
登录
查看更多内容
影响因子：
4.7
作者：
Brandenberger, G;Ehrhart, J;Simon, C
通讯作者：
Simon, C
影响因子：
3.9
作者：
Aguilera, Greti
通讯作者：
Aguilera, Greti
影响因子：
10.3
作者：
Babson, Kimberly A.;Feldner, Matthew T.
通讯作者：
Feldner, Matthew T.
影响因子：
10.6
作者：
Breslau, N;Roth, T;Andreski, P
通讯作者：
Andreski, P
影响因子：
4.1
作者：
Blechert, Jens;Michael, Tanja;Wilhelm, Frank H.
通讯作者：
Wilhelm, Frank H.