Ann Arbor Veterans Healthcare System, Mental Health Service (116C), 2215 Fuller Rd., Ann Arbor, MI 48105, USA; University of Michigan Medical School, Departments of Psychiatry and Neurology, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA.
Ann Arbor Veterans Healthcare System, Mental Health Service (116C), 2215 Fuller Rd., Ann Arbor, MI 48105, USA.
Psychiatry Res. 2017 Oct;256:118-123. doi: 10.1016/j.psychres.2017.06.044. Epub 2017 Jun 14.
Sleep disturbances (SD) are pronounced in Veterans with posttraumatic stress disorder (PTSD). In clinical trials, SD have been shown to limit the effectiveness of evidence-based treatments for non-PTSD disorders. The purpose of this study was to investigate the relationships between pretreatment SD and the effectiveness of Prolonged Exposure (PE) therapy for Veterans with PTSD. Twenty-one Veterans completed the Pittsburgh Sleep Quality Index (PSQI) and the Clinician Administered PTSD Scale upon presenting to a PTSD specialty clinic. Veterans completed the PTSD Symptom Checklist-Civilian (PCL-C) at the initiation of PE and biweekly thereafter for the duration of treatment (96 total assessments). Correlations and hierarchical linear modeling were utilized to examine the potential impact of baseline sleep variables on the slope and magnitude of treatment outcomes. Higher PSQI total scores, and higher sleep latency and sleep medication use subscale scores were associated with higher PCL-C scores at baseline. Veterans evidenced significant reductions in PTSD symptoms during the course of the treatment study. Total PSQI scores and composites were not associated with reduced effectiveness of PE treatment or the slope of PTSD symptom changes. Sleep disturbances do not preclude Veterans from benefits derived from engagement in this gold standard PTSD intervention.
睡眠障碍（SD）在患有创伤后应激障碍（PTSD）的退伍军人中表现明显。在临床试验中，SD 已被证明会限制针对非 PTSD 障碍的循证治疗的效果。本研究的目的是调查治疗前 SD 与 PTSD 退伍军人接受延长暴露（PE）治疗效果之间的关系。21 名退伍军人在 PTSD 专科诊所就诊时完成了匹兹堡睡眠质量指数（PSQI）和临床医生管理的 PTSD 量表。退伍军人在开始接受 PE 治疗时以及此后每两周进行一次 PTSD 症状清单-平民版（PCL-C）评估，持续治疗 96 次。相关性和分层线性模型用于检查基线睡眠变量对治疗结果的斜率和幅度的潜在影响。PSQI 总分较高，以及睡眠潜伏期和睡眠药物使用分量表得分较高，与基线时的 PCL-C 得分较高相关。退伍军人在治疗研究过程中表现出 PTSD 症状的显著减轻。PSQI 总分和综合评分与 PE 治疗效果的降低或 PTSD 症状变化的斜率无关。睡眠障碍不会妨碍退伍军人从参与这种 PTSD 标准干预中获得益处。
