In-Home Sleep Recordings in Military Veterans With Posttraumatic Stress Disorder Reveal Less REM and Deep Sleep <1 Hz
In-Home Sleep Recordings in Military Veterans With Posttraumatic Stress Disorder Reveal Less REM and Deep Sleep <1 Hz
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患有创伤后应激障碍的退伍军人的家庭睡眠记录显示，快速眼动睡眠和深度睡眠<1 Hz 较少
DOI：
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发表时间：
2018
影响因子：
2.9
通讯作者：
T. Coleman
中科院分区：
文献类型：
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作者：
J. Onton;S. Matthews;Dae Y. Kang;T. Coleman
患有创伤后应激障碍（PTSD）的退伍军人经常报告睡眠质量欠佳，通常被描述为不明原因的缺乏安宁。这些经验有时很难在睡眠实验室评估中客观量化。在这里，我们使用一种简化的睡眠评估工具来记录家中的双通道脑电图（EEG），同时收集皮电活动（EDA）和加速。来自单个前额通道的数据被转换成整个夜间的频谱图，并使用全自动算法对睡眠阶段进行分类。在这项研究中，研究人员分析了71名对照受试者和60名与军事相关的PTSD受试者在轻度、高深度（1 - 3 Hz）、低深度（<1 Hz）和快速眼动（REM）睡眠阶段所花费的时间百分比，以及睡眠效率和睡眠碎片化。结果显示，创伤后应激障碍患者在快速眼动睡眠（p < 0.0001）和低深度睡眠（p = 0.001）中所占比例较小，而在高深度睡眠中所占比例较大（p < 0.0001）。Hi+Lo组合深度睡眠的百分比在两组之间没有差异。所有睡眠者通常在Lo睡眠时出现EDA峰值，而在Hi、深度睡眠时没有；然而，创伤后应激障碍睡眠者更有可能缺乏EDA峰值，这通常与缺乏深睡眠同时发生。所有受试者的线性回归显示，PTSD睡眠者快速眼动睡眠百分比的下降与年龄、哌唑嗪、SSRIs和SNRIs有关（p < 0.02），而PTSD组的Lo Deep下降和Hi Deep增加不能被本研究的任何因素所解释（p < 0.005）。仅PTSD组的线性回归模型显示，通过抑郁、焦虑和压力量表（DASS; p < 0.00001）测量，REM减少与自我报告的抑郁相关。DASS焦虑与REM时间增加相关（p < 0.0001）。这项研究表明，患有创伤后应激障碍的睡眠者的睡眠模式发生了改变，这可以部分归因于年龄和药物使用；然而，与创伤后应激障碍相关的深度睡眠差异无法与任何已知因素联系起来。使用几种药物[哌唑嗪，选择性5 -羟色胺再摄取抑制剂（SSRIs）， 5 -羟色胺-去甲肾上腺素再摄取抑制剂（SNRIs）；p < 0.03]， SSRIs与睡眠效率较低（b = -3.3±0.95;p = 0.0005）和睡眠破碎度较高（b = -1.7±0.51;p = 0.0009）相关。抗精神病药物与睡眠效率较低相关（b = -4.9±1.4;p = 0.0004）。SSRIs、抗精神病药物和抑郁症对睡眠效率有负面影响（p < 0.008）。睡眠碎片增加与SSRIs、SNRIs和焦虑相关（p < 0.009），而哌唑嗪和抗精神病药物与睡眠碎片减少相关（p < 0.05）。
Veterans with posttraumatic stress disorder (PTSD) often report suboptimal sleep quality, often described as lack of restfulness for unknown reasons. These experiences are sometimes difficult to objectively quantify in sleep lab assessments. Here, we used a streamlined sleep assessment tool to record in-home 2-channel electroencephalogram (EEG) with concurrent collection of electrodermal activity (EDA) and acceleration. Data from a single forehead channel were transformed into a whole-night spectrogram, and sleep stages were classified using a fully automated algorithm. For this study, 71 control subjects and 60 military-related PTSD subjects were analyzed for percentage of time spent in Light, Hi Deep (1–3 Hz), Lo Deep (<1 Hz), and rapid eye movement (REM) sleep stages, as well as sleep efficiency and fragmentation. The results showed a significant tendency for PTSD sleepers to spend a smaller percentage of the night in REM (p < 0.0001) and Lo Deep (p = 0.001) sleep, while spending a larger percentage of the night in Hi Deep (p < 0.0001) sleep. The percentage of combined Hi+Lo Deep sleep did not differ between groups. All sleepers usually showed EDA peaks during Lo, but not Hi, Deep sleep; however, PTSD sleepers were more likely to lack EDA peaks altogether, which usually coincided with a lack of Lo Deep sleep. Linear regressions with all subjects showed that a decreased percentage of REM sleep in PTSD sleepers was accounted for by age, prazosin, SSRIs and SNRIs (p < 0.02), while decreased Lo Deep and increased Hi Deep in the PTSD group could not be accounted for by any factor in this study (p < 0.005). Linear regression models with only the PTSD group showed that decreased REM correlated with self-reported depression, as measured with the Depression, Anxiety, and Stress Scales (DASS; p < 0.00001). DASS anxiety was associated with increased REM time (p < 0.0001). This study shows altered sleep patterns in sleepers with PTSD that can be partially accounted for by age and medication use; however, differences in deep sleep related to PTSD could not be linked to any known factor. With several medications [prazosin, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs); p < 0.03], as well as SSRIs were associated with less sleep efficiency (b = -3.3 ± 0.95; p = 0.0005) and more sleep fragmentation (b = -1.7 ± 0.51; p = 0.0009). Anti-psychotics were associated with less sleep efficiency (b = -4.9 ± 1.4; p = 0.0004). Sleep efficiency was negatively impacted by SSRIs, antipsychotic medications, and depression (p < 0.008). Increased sleep fragmentation was associated with SSRIs, SNRIs, and anxiety (p < 0.009), while prazosin and antipsychotic medications correlated with decreased sleep fragmentation (p < 0.05).
喹硫平、利培酮或从未治疗过的精神分裂症患者的睡眠质量和结构。
影响因子：
2.9
作者：
Keshavan,MatcheriS;Prasad,KonasaleM;Montrose,DebraM;Miewald,JeanM;Kupfer,DavidJ
通讯作者：
Kupfer,DavidJ
影响因子：
4.1
作者：
EHLERS, CL;REED, TK;HENRIKSEN, SJ
通讯作者：
HENRIKSEN, SJ