University of New South Wales, Sydney, Australia.
Sleep. 2010 Jan;33(1):69-74. doi: 10.1093/sleep/33.1.69.
This study investigated the extent to which sleep disturbance in the period immediately prior to a traumatic event predicted development of subsequent psychiatric disorder.
Prospective design cohort study.
Four major trauma hospitals across Australia.
A total of 1033 traumatically injured patients were initially assessed during hospital admission and followed up at 3 months (898) after injury.
Lifetime psychiatric disorder was assessed in hospital with the Mini-International Neuropsychiatric Interview. Sleep disturbance in the 2 weeks prior to injury was also assessed using the Sleep Impairment Index. The prevalence of psychiatric disorder was assessed 3 months after traumatic injury.
There were 255 (28%) patients with a psychiatric disorder at 3 months. Patients who displayed sleep disturbance prior to the injury were more likely to develop a psychiatric disorder at 3 months (odds ratio: 2.44, 95% CI: 1.62-3.69). In terms of patients who had never experienced a prior disorder (n = 324), 96 patients (30%) had a psychiatric disorder at 3 months, and these patients were more likely to develop disorder if they displayed prior sleep disturbance (odds ratio: 3.16, 95% CI: 1.59-4.75).
These findings provide evidence that sleep disturbance prior to a traumatic event is a risk factor for development of posttraumatic psychiatric disorder.
本研究旨在探讨创伤事件发生前的睡眠障碍程度与随后发生精神障碍的关系。
前瞻性设计队列研究。
澳大利亚四家主要创伤医院。
共有 1033 名创伤患者在住院期间进行了初步评估，并在受伤后 3 个月（898 人）进行了随访。
在医院使用 Mini-国际神经精神访谈评估终身精神障碍。使用睡眠障碍指数评估受伤前 2 周的睡眠障碍。在创伤后 3 个月评估精神障碍的患病率。
3 个月时有 255 名（28%）患者患有精神障碍。在受伤前有睡眠障碍的患者在 3 个月时更有可能患上精神障碍（优势比：2.44，95%可信区间：1.62-3.69）。对于从未经历过先前障碍的患者（n=324），有 96 名（30%）患者在 3 个月时患有精神障碍，如果这些患者在受伤前有睡眠障碍，则更有可能患上障碍（优势比：3.16，95%可信区间：1.59-4.75）。
这些发现提供了证据表明，创伤事件发生前的睡眠障碍是发生创伤后精神障碍的一个危险因素。
