Zhang Ye, Ren Rong, Yang Ling-Hui, Tang Xiang-Dong
Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2021 Jan;52(1):28-32. doi: 10.12182/20210160201.
Post-traumatic stress disorder (PTSD) is characterized by intrusive emotional memory, alertness and avoidance after individuals suffer from one or more traumatic events. With the exception of manifestations, sleep disturbances are also considered to be the core symptoms of PTSD. This article mainly discussed insomnia, nightmares, obstructive sleep apnea (OSA), and periodic limb movement during sleep (PLMS) in patients with PTSD. Existing evidence suggested that insomnia is a predictor of the development of PTSD. Cognitive behavioral therapy for insomnia is an important research direction for treating insomnia in PTSD patients. Nightmares are also the core symptom of PTSD. Prazosin and image rehearsal therapy are effective therapies to treat post-traumatic nightmares. The co-occurrence of obstructive sleep apnea (OSA) is over 40% in patients with PTSD. Preliminary studies have shown that continuous positive airway pressure therapy can improve PTSD symptoms in patients with PTSD comorbid OSA. In the process of diagnosis and treatment of PTSD patients, it is important to firstly evaluate whether PTSD patient comorbid OSA or insomnia, and then clinicians could further develop an appropriate treatment plan for these patients.
创伤后应激障碍（PTSD）的特征是个体在经历一次或多次创伤事件后出现侵入性情感记忆、警觉性增高和回避行为。除了这些表现外，睡眠障碍也被认为是PTSD的核心症状。本文主要讨论了PTSD患者的失眠、噩梦、阻塞性睡眠呼吸暂停（OSA）和睡眠期周期性肢体运动（PLMS）。现有证据表明，失眠是PTSD发生的一个预测因素。失眠的认知行为疗法是治疗PTSD患者失眠的一个重要研究方向。噩梦也是PTSD的核心症状。哌唑嗪和意象演练疗法是治疗创伤后噩梦的有效疗法。PTSD患者中阻塞性睡眠呼吸暂停（OSA）的共病率超过40%。初步研究表明，持续气道正压通气治疗可改善合并OSA的PTSD患者的PTSD症状。在PTSD患者的诊断和治疗过程中，首先评估PTSD患者是否合并OSA或失眠很重要，然后临床医生可以进一步为这些患者制定合适的治疗方案。
