Nightmares in United States Military Personnel With Sleep Disturbances
Nightmares in United States Military Personnel With Sleep Disturbances
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DOI：
10.5664/jcsm.6990
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发表时间：
2018-01-01
影响因子：
4.3
通讯作者：
Mysliwiec, Vincent
中科院分区：
文献类型：
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作者：
Creamer, Jennifer L.;Brock, Matthew S.;Mysliwiec, Vincent
研究目的：睡眠障碍在美国军人中很常见。尽管他们暴露在战斗和创伤中，但人们对他们中的噩梦知之甚少。本研究的目的是描述有睡眠障碍的美国军人中噩梦的发生率及其相关的临床和多导睡眠图特征。方法：对500名在我们睡眠中心接受睡眠药物评估和多导睡眠图检查的现役美国军人进行回顾。匹兹堡睡眠质量指数和匹兹堡睡眠质量指数附录被用来描述临床上重要的噩梦。结果：31.2%的人每周至少做噩梦，但只有3.9%的人将噩梦作为评估的理由。与创伤相关的噩梦发生在60%的有噩梦的患者中。有噩梦的患者入睡潜伏期(SOL)和快速眼动(REM)睡眠潜伏期(平均SOL/REM睡眠潜伏期分别为16.6/145分钟，P=0.02和P=0.01)较无噩梦患者(平均SOL/REM睡眠潜伏期12.5/126分钟)延长。抑郁(P=.01，相对危险度[RR]3.55[95%CI，2.52-4.98])、焦虑(P=.01，RR 2.57[95%CI，1.93-3.44])、创伤后应激障碍(P=0.01，RR 5.11[95%CI，3.43-7.62])、失眠(P=0.01，RR 1.59[95%CI，结论：临床上有意义的噩梦在有睡眠障碍的美国军人中非常普遍。噩梦与主观和客观的睡眠障碍有关，并经常与其他睡眠和心理健康障碍并存。
Study Objectives: Sleep disturbances are common in United States military personnel. Despite their exposure to combat and trauma, little is known about nightmares in this population. The purpose of this study was to describe the prevalence and associated clinical and polysomnographic characteristics of nightmares in United States military personnel with sleep disturbances.Methods: Retrospective review of 500 active duty United States military personnel who underwent a sleep medicine evaluation and polysomnography at our sleep center. The Pittsburgh Sleep Quality Index and the Pittsburgh Sleep Quality Index-Addendum were used to characterize clinically significant nightmares. Subjective and objective sleep attributes were compared between groups.Results: At least weekly nightmares were present in 31.2%; yet, only 3.9% reported nightmares as a reason for evaluation. Trauma-related nightmares occurred in 60% of those patients with nightmares. Patients with nightmares had increased sleep onset latency (SOL) and rapid eye movement (REM) sleep latency (mean SOL/REM sleep latency 16.6/145 minutes, P =.02 and P =.01 respectively) compared to those without (mean SOL/REM sleep latency 12.5/126 minutes). The comorbid disorders of depression (P =.01, relative risk [RR] 3.55 [95% CI, 2.52-4.98]), anxiety (P =.01, RR 2.57 [95% CI, 1.93-3.44]), posttraumatic stress disorder (P =.01, RR 5.11 [95% CI, 3.43-7.62]), and insomnia (P =.01, RR 1.59 [95% CI, 1.42-1.79]) were all associated with nightmares.Conclusions: Clinically significant nightmares are highly prevalent in United States military personnel with sleep disturbances. Nightmares are associated with both subjective and objective sleep disturbances and are frequently comorbid with other sleep and mental health disorders.