REM sleep and the early development of posttraumatic stress disorder
REM sleep and the early development of posttraumatic stress disorder
复制标题
DOI：
10.1176/appi.ajp.159.10.1696
复制
发表时间：
2002-10-01
影响因子：
17.7
通讯作者：
Nolan, B
中科院分区：
文献类型：
--
作者：
Mellman, TA;Bustamante, V;Nolan, B
目的：创伤后应激障碍（PTSD）一旦确立，其潜在的慢性和治疗耐药性激发了人们对了解该疾病早期发病机制的兴趣。唤醒调节和记忆巩固似乎在决定PTSD的发展中很重要；两者都是睡眠的功能。慢性创伤后应激障碍患者的睡眠结果很复杂，有些矛盾，急性期的数据相当有限。本研究的目的是获取危及生命的经历和受伤后急性期的多导睡眠图记录，并将睡眠持续时间和维持时间以及快速眼动睡眠的时间、强度和连续性与创伤后应激障碍的早期发展联系起来。方法：21名符合研究标准的受伤受试者在接近医疗/手术稳定时间和受伤后一个月内接受至少一次多导睡眠图记录。同时和6周后评估PTSD症状。在随访中比较了有和没有明显PTSD症状的受伤受试者和10名非受伤对照受试者的睡眠测量，并与PTSD严重程度相关。结果：创伤暴露患者的睡眠时间比非创伤暴露患者的睡眠时间更长。创伤后应激障碍症状的发展与阶段转换前快速眼动睡眠的平均持续时间较短和快速眼动睡眠的时间较多有关。结论：创伤性损伤后PTSD症状的发展与快速眼动睡眠的碎片化模式有关。
Objective: The potential for chronicity and treatment resistance once posttraumatic stress disorder (PTSD) has become established has stimulated interest in understanding the early pathogenesis of the disorder. Arousal regulation and memory consolidation appear to be important in determining the development of PTSD; both are functions of sleep. Sleep findings from patients with chronic PTSD are complex and somewhat contradictory, and data from the acute phase are quite limited. The aim of the present study was to obtain polysomnographic recordings during an acute period after life-threatening experiences and injury and to relate measures of sleep duration and maintenance and the timing, intensity, and continuity of REM sleep to the early development of PTSD.Method: Twenty-one injured subjects meeting study criteria received at least one polysomnographic recording close to the time of medical/surgical stabilization and within a month of injury. PTSD symptoms were assessed concurrently and 6 weeks later. Sleep measures were compared among injured subjects with and without significant PTSD symptoms at follow-up and 10 noninjured comparison subjects and were also correlated with PTSD severity.Results: There was more wake time after the onset of sleep in injured, trauma-exposed patients than in noninjured comparison subjects. Development of PTSD symptoms was associated with shorter average duration of REM sleep before a stage change and more periods of REM sleep,Conclusions: The development of PTSD symptoms after traumatic injury is associated with a more fragmented pattern of REM sleep.