Department of Psychiatry, Phoenix Australia Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne, Australia.
Department of Respiratory and Sleep Medicine, Austin Hospital, Melbourne, Australia.
Sleep. 2018 Jan 1;41(1). doi: 10.1093/sleep/zsx188.
This study used ambulatory polysomnography (PSG) to investigate post-traumatic nightmares of post-traumatic stress disorder (PTSD). The key research question was whether post-traumatic nightmares occur in both rapid eye movement (REM) and non-REM sleep, and if so, whether nightmares in each sleep stage differed in content, phenomenology, and heart rate response. Underlying sleep disorders were investigated in an exploratory way.
Thirty-five treatment-seeking veterans, current serving military members, and emergency service personnel undertook full PSG using the Compumedics (Melbourne, Australia) SomtePSG V1 system, during an inpatient psychiatric admission. The PSG recording included an event button to be pressed when a nightmare occurred, allowing us to determine the stage of sleep, changes in heart rate, and associated sleep events. The content and phenomenological features of participants' nightmares were recorded.
Of the 35 participants, 29 reported a nightmare during their sleep study, but only 21 pressed the event button and could recall the content of one or more nightmare. This yielded sleep and nightmare data for 24 nightmares. Of the 24, 10 nightmares arose from REM sleep and 14 from non-REM (stages N1 and N2). Seven were accurate trauma replays and 17 were non-replay or a mixture of replay and non-replay. Most nightmares were associated with respiratory or leg movement events and increase in heart rate on awakening.
Post-traumatic nightmares of PTSD occur in both REM and non-REM sleep and are commonly associated with other sleep disturbances. These findings have important treatment implications.
本研究使用动态多导睡眠图（PSG）来研究创伤后应激障碍（PTSD）的创伤后噩梦。关键研究问题是创伤后噩梦是否发生在快速眼动（REM）和非快速眼动睡眠中，如果是，那么每个睡眠阶段的噩梦在内容、现象学和心率反应方面是否存在差异。以探索性的方式研究了潜在的睡眠障碍。
35 名接受治疗的退伍军人、现役军人和应急服务人员在精神病住院期间使用 Compumedics（澳大利亚墨尔本）SomtePSG V1 系统进行了全面 PSG。PSG 记录包括一个事件按钮，当发生噩梦时按下该按钮，可以确定睡眠阶段、心率变化和相关的睡眠事件。记录了参与者噩梦的内容和现象学特征。
在 35 名参与者中，有 29 名在睡眠研究期间报告了噩梦，但只有 21 名按下了事件按钮并能回忆起一个或多个噩梦的内容。这产生了 24 个噩梦的睡眠和噩梦数据。在这 24 个噩梦当中，有 10 个来自 REM 睡眠，14 个来自非快速眼动（N1 和 N2 阶段）。其中 7 个是准确的创伤重播，17 个是非重播或重播和非重播的混合。大多数噩梦与呼吸或腿部运动事件有关，并在醒来时心率增加。
创伤后应激障碍的创伤后噩梦发生在 REM 和非快速眼动睡眠中，通常与其他睡眠障碍有关。这些发现具有重要的治疗意义。
