Sleep & Human Health Institute, Albuquerque, NM, USA; Maimonides Sleep Arts & Sciences, Ltd, Albuquerque, NM, USA; Los Alamos Medical Center, Los Alamos, NM, USA.
Sleep & Human Health Institute, Albuquerque, NM, USA; Maimonides Sleep Arts & Sciences, Ltd, Albuquerque, NM, USA.
Sleep Med Rev. 2015 Dec;24:37-45. doi: 10.1016/j.smrv.2014.11.001. Epub 2014 Nov 21.
Posttraumatic stress disorder (PTSD) and sleep-disordered breathing (SDB) are common disorders, but limited data address their co-morbidity. Emerging research indicates PTSD and SDB may co-occur more frequently than expected and may impact clinical outcomes. This review describes historical developments that first raised suspicions for a co-morbid relationship between PTSD and SDB, including barriers to the recognition and diagnosis of this co-morbidity. Objective diagnostic data from polysomnography studies in PTSD patients reveal widely varying prevalence rates for co-morbidity (0-90%). Use of standard, recommended technology (nasal cannula pressure transducer) versus older, less reliable technology (thermistor/thermocouple) appears to have influenced objective data acquisition and therefore SDB rates in sleep studies on PTSD patients. Studies using higher quality respiratory sensors demonstrated the highest prevalence of SDB in PTSD patients. Clinical relevance, theoretical models and research recommendations are discussed. The lack of widely acknowledged, tested, or proven explanatory models and pathophysiological mechanisms to understand the relationship between these two disorders may prove formidable barriers to further investigations on prevalence and clinical relevance, albeit both conditions are associated with waking or sleeping hyperarousal activity, which may inform future studies.
创伤后应激障碍（PTSD）和睡眠呼吸障碍（SDB）是常见疾病，但有关两者合并症的资料有限。新出现的研究表明，PTSD 和 SDB 的合并症比预期的更为常见，可能会影响临床结果。这篇综述描述了最初引起 PTSD 和 SDB 合并症怀疑的历史发展，包括对这种合并症的认识和诊断的障碍。来自 PTSD 患者多导睡眠图研究的客观诊断数据显示，合并症的患病率差异很大（0-90%）。使用标准、推荐的技术（鼻导管压力换能器）与较旧、不太可靠的技术（热敏电阻/热电偶）似乎会影响睡眠研究中 PTSD 患者的客观数据采集，从而影响 SDB 发生率。使用更高质量呼吸传感器的研究表明，PTSD 患者的 SDB 患病率最高。本文讨论了其临床意义、理论模型和研究建议。缺乏广泛认可、测试或证实的解释模型和病理生理学机制来理解这两种疾病之间的关系，这可能是进一步研究其患病率和临床相关性的巨大障碍，尽管这两种疾病都与清醒或睡眠时的过度唤醒活动有关，这可能为未来的研究提供信息。
