创伤后应激障碍中噩梦和失眠的治疗:当前证据综述。

Treating nightmares and insomnia in posttraumatic stress disorder: a review of current evidence.

机构信息

University of California, San Diego and Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, MC116B, San Diego, CA 92161, United States.

出版信息

Neuropharmacology. 2012 Feb;62(2):576-85. doi: 10.1016/j.neuropharm.2011.02.029. Epub 2011 Mar 17.

Abstract

Emerging evidence supports the notion of disrupted sleep as a core component of Posttraumatic Stress Disorder (PTSD). Effective treatments for nighttime PTSD symptoms are critical because sleep disruption may be mechanistically linked to development and maintenance of PTSD and is associated with significant distress, functional impairment, and poor health. This review aimed to describe the state of science with respect to the impact of the latest behavioral and pharmacological interventions on posttraumatic nightmares and insomnia. Published studies that examined evidence for therapeutic effects upon sleep were included. Some behavioral and pharmacological interventions show promise, especially for nightmares, but there is a need for controlled trials that include valid sleep measures and are designed to identify treatment mechanisms. Our ability to treat PTSD-related sleep disturbances may be improved by moving away from considering sleep symptoms in isolation and instead conducting integrative studies that examine sequential or combined behavioral and/or pharmacological treatments targeting both the daytime and nighttime aspects of PTSD. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.

摘要

新出现的证据支持睡眠紊乱是创伤后应激障碍(PTSD)的核心组成部分这一观点。针对夜间 PTSD 症状的有效治疗方法至关重要,因为睡眠紊乱可能与 PTSD 的发展和维持在机制上有关,并且与显著的痛苦、功能障碍和健康状况不佳有关。本综述旨在描述关于最新行为和药物干预措施对创伤后噩梦和失眠影响的科学现状。纳入了研究睡眠治疗效果的已发表研究。一些行为和药物干预措施显示出希望,特别是针对噩梦,但需要进行包括有效睡眠测量并旨在确定治疗机制的对照试验。通过避免孤立地考虑睡眠症状,而是进行综合研究,检查针对 PTSD 白天和夜间两方面的序贯或联合行为和/或药物治疗,我们治疗 PTSD 相关睡眠障碍的能力可能会提高。本文是题为“创伤后应激障碍”的特刊的一部分。

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