van Liempt S, Vermetten E, de Groen J H M, Westenberg H G M
Onderzoekscentrum Militaire Geestelijke Gezondheidszorg Defensie, Centraal Miliair Hospitaal, Postbus 90.000, 3509 AA Utrecht, Netherlands.
Tijdschr Psychiatr. 2007;49(9):629-38.
Nightmares and insomnia are experienced by 70% of patients suffering from post-traumatic stress disorder (PTSD). These sleep problems are often resistant to treatment and exert a strong negative influence on the quality of life. In the last few decades several studies have reported on the characteristics of sleep disturbances in PTSD.
To provide an overview of objective features of sleep disturbances - as opposed to self-report methods - in patients with PTSD.
Articles on this topic, published in peer-reviewed journals between 1980 and the present, were retrieved from Medline and Embase, using the search terms 'PTSD', 'sleep', 'nightmares', 'insomnia', 'polysomnography'.
Studies reported on changes in sleep efficiency, arousal regulation, motor activity during sleep, rem characteristics and delta sleep activity during sleep. Also, correlations were found between nightmares and sleep apnoea in ptsd. In some studies on sleep disturbance no objective sleep disturbances were found in PTSD patients. However, most studies on PTSD related sleep disturbances were conducted in small, heterogeneous groups, and results were therefore inconsistent. Even the results of larger and more homogeneous studies were sometimes contradictory.
There is a discrepancy between the clinical importance of sleep problems in PTSD and unambiguous objective sleep disorders. Future research should try to establish objective criteria for identifying the altered sleep patterns in PTSD. These criteria should help us to understand the neurobiological mechanisms of sleep disturbances in PTSD and develop new treatment strategies.
70%的创伤后应激障碍（PTSD）患者会经历噩梦和失眠。这些睡眠问题往往难以治疗，并对生活质量产生严重负面影响。在过去几十年里，已有多项研究报道了PTSD患者睡眠障碍的特征。
概述PTSD患者睡眠障碍的客观特征——与自我报告方法不同。
使用检索词“PTSD”“睡眠”“噩梦”“失眠”“多导睡眠图”，从Medline和Embase数据库中检索1980年至今发表在同行评审期刊上的关于该主题的文章。
研究报告了睡眠效率、觉醒调节、睡眠期间的运动活动、快速眼动（REM）特征以及睡眠期间的慢波睡眠活动的变化。此外，还发现PTSD患者的噩梦与睡眠呼吸暂停之间存在相关性。在一些关于睡眠障碍的研究中，未在PTSD患者中发现客观的睡眠障碍。然而，大多数关于PTSD相关睡眠障碍的研究是在小型、异质性群体中进行的，因此结果不一致。即使是规模较大、同质性较高的研究结果有时也相互矛盾。
PTSD睡眠问题的临床重要性与明确的客观睡眠障碍之间存在差异。未来的研究应尝试建立识别PTSD患者睡眠模式改变的客观标准。这些标准应有助于我们理解PTSD睡眠障碍的神经生物学机制，并制定新的治疗策略。
