Sleep complaints are not corroborated by objective sleep measures in post-traumatic stress disorder: a 1-year prospective study in survivors of motor vehicle crashes
Sleep complaints are not corroborated by objective sleep measures in post-traumatic stress disorder: a 1-year prospective study in survivors of motor vehicle crashes
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DOI：
10.1046/j.1365-2869.2003.00334.x
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发表时间：
2003-03-01
影响因子：
4.4
通讯作者：
Lavie, P
中科院分区：
文献类型：
--
作者：
Klein, E;Koren, D;Lavie, P
睡眠障碍是创伤后应激障碍 (PTSD) 患者的常见症状。然而，针对 PTSD 睡眠的实验室研究提供了客观睡眠障碍的不一致证据。以往大多数研究的一个主要缺点是，它们是在患有慢性创伤后应激障碍的患者中进行回顾性研究，这些患者通常并发精神疾病和药物滥用。因此，对于最近遭受创伤的受试者睡眠障碍的发展知之甚少。在这项研究中，对 102 名机动车碰撞 (MVC) 幸存者进行了为期一年的跟踪调查。十九名因择期手术住院的受试者作为对照组。使用迷你睡眠问卷和睡眠习惯问卷评估主观睡眠质量。此外，碰撞后 1 周、3 个月和 12 个月还获得了 48 小时的活动记录。 12 个月时，进行了结构化临床访谈 (SCID)，以得出 PTSD 的正式诊断。 26 名 MVC 幸存者（但没有一个对照对象）符合 PTSD 的诊断标准。虽然患有 PTSD 的 MVC 幸存者报告睡眠质量明显较差，这反映在迷你睡眠问卷的得分显着较高，但三组之间的活动记录测量没有显着差异，基本正常。这些结果是在创伤时没有活动性精神症状证据且未服用精神药物或催眠药物的受试者中获得的，进一步支持了之前的多导睡眠图（PSG）研究，表明睡眠感知的改变，而不是睡眠障碍本身，可能是 PTSD 的关键问题。
Disturbed sleep is a common complaint among patients with post-traumatic stress disorder (PTSD). However, laboratory studies of sleep in PTSD have provided inconsistent evidence of objective sleep disturbances. A major shortcoming of most previous studies is the fact that they were performed retrospectively in patients with chronic PTSD, often complicated by comorbid psychiatric disorders and drug abuse. Thus, little is known about the development of sleep disturbances in recently traumatized subjects. In this study, 102 motor vehicle collision (MVC) survivors were followed from the time of collision throughout 1 year. Nineteen subjects hospitalized for elective surgery served as a comparison group. Subjective quality of sleep was assessed using the mini-Sleep Questionnaire and the Sleep Habit Questionnaire. In addition, a 48-h actigraphic recording was obtained 1 week, 3 and 12 months after the collision. At 12 months, a structured clinical interview (SCID) was administered to reach a formal diagnosis of PTSD. Twenty-six of the MVC survivors, but none of the comparison subjects, met the diagnostic criteria for PTSD. While MVC survivors with PTSD reported markedly poorer sleep as reflected by significantly higher scores on the mini-Sleep Questionnaire, there were no significant differences between the three groups on the actigraphic measures that were largely normal. These results, which were obtained in subjects with no evidence of active psychiatric symptoms at the time of trauma and free of psychotropic or hypnotic medications, further support previous polysomnographic (PSG) studies suggesting that altered sleep perception, rather than sleep disturbance per se , may be the key problem in PTSD.