Department of Psychology, University of North Texas, Denton, TX.
Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Sleep. 2020 Oct 13;43(10). doi: 10.1093/sleep/zsaa065.
To examine sleep disorder symptom reports at baseline and posttreatment in a sample of active duty U.S. Army Soldiers receiving treatment for posttraumatic stress disorder (PTSD). Explore sleep-related predictors of outcomes.
Sleep was evaluated in 128 participants in a parent randomized clinical trial comparing Spaced formats of Prolonged Exposure (PE) or Present Centered Therapy and a Massed format of PE. In the current study, Spaced formats were combined and evaluated separately from Massed.
At baseline, the average sleep duration was < 5 h per night on weekdays/workdays and < 6 h per night on weekends/off days. The majority of participants reported clinically significant insomnia, clinically significant nightmares, and probable sleep apnea and approximately half reported excessive daytime sleepiness at baseline. Insomnia and nightmares improved significantly from baseline to posttreatment in all groups, but many patients reported clinically significant insomnia (>70%) and nightmares (>38%) posttreatment. Excessive daytime sleepiness significantly improved only in the Massed group, but 40% continued to report clinically significant levels at posttreatment. Short sleep (Spaced only), clinically significant insomnia and nightmares, excessive daytime sleepiness, and probable sleep apnea (Massed only) at baseline predicted higher PTSD symptoms across treatment course. Short weekends/off days sleep predicted lower PTSD symptom improvement in the Spaced treatments.
Various sleep disorder symptoms were high at baseline, were largely unchanged with PTSD treatment, and were related to worse PTSD treatment outcomes. Studies are needed with objective sleep assessments and targeted sleep disorders treatments in PTSD patients.
NCT01049516.
在接受创伤后应激障碍（PTSD）治疗的现役美国陆军士兵样本中，检查基线和治疗后睡眠障碍症状报告。探讨与睡眠相关的预后预测因素。
在一项比较延长暴露（PE）的间隔格式或当前中心治疗与集中格式的 PE 的父母随机临床试验中，对 128 名参与者进行睡眠评估。在当前研究中，间隔格式与集中格式分开进行组合和评估。
基线时，工作日/平日的平均睡眠时间<5 小时，周末/休息日的平均睡眠时间<6 小时。大多数参与者报告存在临床显著的失眠、临床显著的噩梦以及可能的睡眠呼吸暂停，大约一半的参与者在基线时报告存在日间过度嗜睡。所有组的失眠和噩梦均从基线显著改善到治疗后，但许多患者报告治疗后仍存在临床显著的失眠（>70%）和噩梦（>38%）。仅集中组的日间过度嗜睡显著改善，但 40%的患者在治疗后仍报告存在临床显著水平。基线时的短睡眠（仅间隔）、临床显著的失眠和噩梦、日间过度嗜睡以及可能的睡眠呼吸暂停（仅集中）预测整个治疗过程中 PTSD 症状更高。短周末/休息日睡眠预测间隔治疗中 PTSD 症状改善程度较低。
各种睡眠障碍症状在基线时很高，在 PTSD 治疗后基本没有变化，与更差的 PTSD 治疗结果相关。需要对 PTSD 患者进行客观睡眠评估和有针对性的睡眠障碍治疗研究。
NCT01049516。
