Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands; Psychiatric Sleep Center Assen, Mental Health Services Drenthe, the Netherlands.
Department of Clinical Psychology & Experimental Psychopathology, University of Groningen, Groningen, the Netherlands; Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands.
Sleep Med Rev. 2020 Oct;53:101331. doi: 10.1016/j.smrv.2020.101331. Epub 2020 May 21.
Severe, persistent and disabling grief occurs among a sizable minority experiencing bereavement, with diagnostic manuals newly including complicated grief (CG) disorders. Sleep disturbances/disorders have been established as worsening affective and stress-related conditions. However, the role of sleep difficulties in bereavement and CG has not received similar scientific attention. We therefore conducted a systematic review with narrative syntheses on this topic to clarify the role of sleep in bereavement (PROSPERO: CRD42018093145). We searched PubMed, Web of Science and PsychInfo for peer-reviewed English-language articles including (at least one) bereaved sample and sleep disturbance measure. We identified 85 articles on 12.294 participants. We answered seven pre-defined research questions demonstrating: high prevalence of sleep disturbances in bereavement; positive associations of grief intensity with sleep difficulties; preliminary indications of risk factors of post-loss sleep disturbance; higher prevalence of sleep disturbances in CG, enhanced by psychiatric comorbidity (i.e., depression); and initial evidence of causal relationships between (complicated) grief and sleep. Grief therapy partly improves sleep difficulties, yet no intervention studies have specifically targeted sleep problems in bereaved persons. Causal relationships between sleep and grief require further examination in intensive longitudinal investigations, including randomized trials, thereby clarifying whether treating sleep problems enhances CG treatment effects.
在经历丧亲之痛的人群中，相当一部分人会出现严重、持续和致残的悲伤，新的诊断手册包括了复杂悲伤（CG）障碍。睡眠障碍/紊乱已被确定为恶化情感和与压力相关的状况。然而，睡眠困难在丧亲和 CG 中的作用尚未得到类似的科学关注。因此，我们就这一主题进行了系统评价和叙述性综合，以阐明睡眠在丧亲之痛中的作用（PROSPERO：CRD42018093145）。我们在 PubMed、Web of Science 和 PsychInfo 上搜索了同行评议的英文文章，其中包括（至少一个）丧亲样本和睡眠障碍测量。我们确定了 85 篇关于 12294 名参与者的文章。我们回答了七个预先定义的研究问题，表明：丧亲之痛中睡眠障碍的高发率；悲伤强度与睡眠困难呈正相关；初步表明与丧失后睡眠障碍相关的风险因素；CG 中睡眠障碍的更高发生率，由精神共病（即抑郁症）增强；以及（复杂）悲伤和睡眠之间因果关系的初步证据。悲伤治疗部分改善了睡眠困难，但没有干预研究专门针对丧亲者的睡眠问题。睡眠和悲伤之间的因果关系需要在密集的纵向研究中进一步研究，包括随机试验，从而阐明治疗睡眠问题是否可以增强 CG 治疗效果。
