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创伤后应激障碍和创伤暴露患者的主观和客观睡眠测量。

Subjectively and objectively measured sleep with and without posttraumatic stress disorder and trauma exposure.

机构信息

Department of Psychiatry, Howard University, Washington, DC, USA.

出版信息

Sleep. 2012 Jul 1;35(7):957-65. doi: 10.5665/sleep.1960.

Abstract

STUDY OBJECTIVES

Although reports of sleep disturbances are common among individuals with posttraumatic stress disorder (PTSD), results of polysomnographic (PSG) studies have inconsistently documented abnormalities and have therefore suggested "sleep state misperception." The authors' study objectives were to compare sleep parameters measured objectively and subjectively in the laboratory and at home in civilians with and without trauma exposure and PTSD.

DESIGN

Cross-sectional study.

SETTING

PSG recordings in a sleep laboratory and actigraphic recordings in participants' homes.

PARTICIPANTS

One hundred three urban-residing African Americans with and without trauma exposure and PTSD who participated in a larger study.

INTERVENTIONS

N/A.

MEASUREMENTS

Sleep parameters (total sleep time [TST], sleep onset latency [SOL], and wake after sleep onset [WASO]) were assessed using laboratory PSG and home actigraphy. A sleep diary was completed in the morning after PSG and actigraphy recordings. Habitual TST, SOL, and WASO were assessed using a sleep questionnaire. The Clinician Administered PTSD Scale was administered to assess participants' trauma exposure and PTSD diagnostic status.

RESULTS

Participants, regardless of their trauma exposure/PTSD status, underestimated WASO in the diary and questionnaire relative to actigraphy and overestimated SOL in the diary relative to PSG. Among participants with current PTSD, TST diary estimates did not differ from the actigraphy measure in contrast with those without current PTSD who overestimated TST. No other significant group differences in discrepancies between subjective and objective sleep measures were found.

CONCLUSIONS

Discrepancies between subjectively and objectively measured sleep parameters were not associated with trauma exposure or PTSD. This challenges prior assertions that individuals with PTSD overreport their sleep disturbances.

摘要

研究目的

尽管创伤后应激障碍(PTSD)患者常报告睡眠障碍,但多导睡眠图(PSG)研究的结果并未一致记录到异常,因此提出了“睡眠状态感知错误”。作者的研究目的是比较有和没有创伤暴露和 PTSD 的平民在实验室和家中通过客观和主观测量的睡眠参数。

设计

横断面研究。

设置

睡眠实验室中的 PSG 记录和参与者家中的活动记录仪记录。

参与者

103 名居住在城市的非裔美国成年人,有和没有创伤暴露和 PTSD,他们参加了一项更大的研究。

干预措施

无。

测量

使用实验室 PSG 和家庭活动记录仪评估睡眠参数(总睡眠时间[TST]、睡眠潜伏期[SOL]和睡眠后觉醒[WASO])。PSG 和活动记录仪记录后,在早晨填写睡眠日记。使用睡眠问卷评估习惯性 TST、SOL 和 WASO。使用临床医生管理的 PTSD 量表评估参与者的创伤暴露和 PTSD 诊断状况。

结果

无论参与者是否有创伤暴露/ PTSD 状况,他们在日记和问卷中对 WASO 的估计都低于活动记录仪,在日记中对 SOL 的估计都高于 PSG。在当前患有 PTSD 的参与者中,与没有当前 PTSD 的参与者相比,TST 日记估计与活动记录仪测量值没有差异,后者高估了 TST。在主观和客观睡眠测量之间的差异方面,没有发现其他显著的组间差异。

结论

主观和客观测量的睡眠参数之间的差异与创伤暴露或 PTSD 无关。这挑战了先前认为 PTSD 患者会过度报告其睡眠障碍的说法。

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