Krakow B, Lowry C, Germain A, Gaddy L, Hollifield M, Koss M, Tandberg D, Johnston L, Melendrez D
UNM Sleep Research, University of New Mexico Health Sciences Center, 4775 Indian School Road NE, Suite 305, Albuquerque, NM 87110, USA.
J Psychosom Res. 2000 Nov;49(5):291-8. doi: 10.1016/s0022-3999(00)00147-1.
To assess the impact of treatment for co-morbid sleep-disordered breathing (SDB) on patients with nightmares and post-traumatic stress.
Twenty-three chronic nightmare sufferers (15 with post-traumatic stress disorder, PTSD) who also suffered co-morbid SDB (obstructive sleep apnea, OSA, n=16; upper airway resistance syndrome, UARS, n=7) completed a telephone interview, on average, 21 months after having been offered treatment for SDB at a university sleep disorders clinic.
At follow-up, 14 reported maintaining treatment (Treatment Group) and 9 reported discontinuing treatment (No-Treatment Group). More patients in the Treatment Group reported improvement in sleep (93% vs. 33%) and in daytime well being (93% vs. 33%) compared with those in the No-Treatment group. The Treatment Group reported a median improvement in nightmares of 85% compared with a median 10% worsening in the No-Treatment Group. In the PTSD subset (n=15), nine in the Treatment Group reported a median 75% improvement in PTSD symptoms whereas six in the No-Treatment Group reported a median 43% worsening.
In this small sample of patients, treatment of SDB was associated with improvements in nightmares and PTSD. Relationships between nightmares, PTSD and SDB are discussed.
评估合并睡眠呼吸障碍（SDB）的治疗对噩梦及创伤后应激患者的影响。
23名慢性噩梦患者（其中15名患有创伤后应激障碍，PTSD），同时合并SDB（阻塞性睡眠呼吸暂停，OSA，n = 16；上气道阻力综合征，UARS，n = 7），在大学睡眠障碍诊所接受SDB治疗后平均21个月完成了一次电话访谈。
随访时，14名报告维持治疗（治疗组），9名报告停止治疗（未治疗组）。与未治疗组相比，治疗组更多患者报告睡眠改善（93%对33%）和日间幸福感改善（93%对33%）。治疗组报告噩梦改善中位数为85%，而未治疗组中位数恶化10%。在PTSD亚组（n = 15）中，治疗组9名患者报告PTSD症状改善中位数为75%，而未治疗组6名患者报告中位数恶化43%。
在这个小样本患者中，SDB治疗与噩梦及PTSD改善相关。讨论了噩梦、PTSD和SDB之间的关系。
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