Singareddy Ravi Kumar, Balon Richard
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA.
Ann Clin Psychiatry. 2002 Sep;14(3):183-90. doi: 10.1023/a:1021190620773.
Posttraumatic stress disorder (PTSD) is often associated with sleep disturbances. In this review, we focus on the published literature on subjective and objective findings of sleep in patients with PTSD. Insomnia and nightmares are most commonly reported subjective sleep disturbances. Polysomnographic investigations have frequently reported rapid eye movement (REM) sleep abnormalities in PTSD. However, studies have not been consistent about the type of REM sleep dysfunction in PTSD patients. Antidepressants such as nefazodone, trazodone, fluvoxamine, and imagery rehearsal therapy are found to be beneficial in the treatment of PTSD associated sleep disturbances as well as core symptoms of this anxiety disorder. We propose use of such modalities of treatment in PTSD patients with predominant sleep disturbances. Further studies are required to clarify polysomnographic sleep changes especially role of REM sleep dysregulation and treatment of sleep disturbances in PTSD.
创伤后应激障碍(PTSD)常与睡眠障碍相关。在本综述中,我们聚焦于已发表的有关PTSD患者睡眠主观及客观研究结果的文献。失眠和噩梦是最常报告的主观睡眠障碍。多导睡眠图检查经常报告PTSD患者存在快速眼动(REM)睡眠异常。然而,关于PTSD患者REM睡眠功能障碍的类型,各研究结果并不一致。已发现奈法唑酮、曲唑酮、氟伏沙明等抗抑郁药以及意象演练疗法在治疗与PTSD相关的睡眠障碍以及这种焦虑症的核心症状方面有益。我们建议在以睡眠障碍为主的PTSD患者中使用此类治疗方式。需要进一步研究以阐明多导睡眠图的睡眠变化,尤其是REM睡眠失调在PTSD中的作用以及睡眠障碍的治疗。