Department of Psychology, Florida State University, Tallahassee, FL, USA.
Department of Psychology, Ohio University, Athens, OH, USA.
J Sleep Res. 2018 Feb;27(1):64-72. doi: 10.1111/jsr.12589. Epub 2017 Aug 3.
Despite the high levels of comorbidity between post-traumatic stress disorder (PTSD) and sleep disturbance, little research has examined the predictors of insomnia and nightmares in this population. The current study tested both PTSD-specific (i.e. PTSD symptoms, comorbid anxiety and depression, nightmares and fear of sleep) and insomnia-specific (i.e. dysfunctional beliefs about sleep, insomnia-related safety behaviours and daily stressors) predictors of sleep quality, efficiency and nightmares in a sample of 30 individuals with PTSD. Participants participated in ecological momentary assessment to determine how daily changes in PTSD- and insomnia-related factors lead to changes in sleep. Multi-level modelling analyses indicated that, after accounting for baseline PTSD symptom severity, PTSD-specific factors were associated with insomnia symptoms, but insomnia-specific factors were not. Only daytime PTSD symptoms and fear of sleep predicted nightmares. Both sleep- and PTSD-related factors play a role in maintaining insomnia among those with PTSD, while nightmares seem to be linked more closely with only PTSD-related factors.
尽管创伤后应激障碍（PTSD）和睡眠障碍之间存在高度的共病性，但很少有研究检查该人群中失眠和噩梦的预测因素。本研究在 30 名 PTSD 个体样本中测试了 PTSD 特异性（即 PTSD 症状、共病焦虑和抑郁、噩梦和睡眠恐惧）和失眠特异性（即睡眠障碍相关信念、失眠相关安全行为和日常压力源）对睡眠质量、效率和噩梦的预测因素。参与者参与了生态瞬时评估，以确定 PTSD 和失眠相关因素的日常变化如何导致睡眠的变化。多层次建模分析表明，在考虑到 PTSD 症状严重程度的基线后，PTSD 特异性因素与失眠症状相关，但失眠特异性因素则不相关。只有日间 PTSD 症状和睡眠恐惧预测了噩梦。睡眠和 PTSD 相关因素在维持 PTSD 患者的失眠方面都发挥了作用，而噩梦似乎与仅与 PTSD 相关的因素更密切相关。
