Brownlow Janeese A, Miller Katherine E, Gehrman Philip R
Department of Psychology, College of Health & Behavioral Sciences, Delaware State University, Dover, Delaware, USA.
Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Curr Treat Options Psychiatry. 2020 Sep;7(3):301-316. doi: 10.1007/s40501-020-00222-y. Epub 2020 Jun 12.
Sleep disturbances, insomnia and recurrent nightmares in particular, are among the most frequently endorsed symptoms of posttraumatic stress disorder (PTSD). The present review provides a summary of the prevalence estimates and methodological challenges presented by sleep disturbances in PTSD, highlights the recent evidence for empirically supported psychotherapeutic and pharmacological interventions for comorbid sleep disturbances implicated in PTSD, and provides a summary of recent findings on integrated and sequential treatment approaches to ameliorate comorbid sleep disturbances in PTSD.
Insomnia, recurrent nightmares, and other sleep disorders are commonly endorsed among individuals with PTSD; however, several methodological challenges contribute to the varying prevalence estimates. Targeted sleep-focused therapeutic interventions can improve sleep symptoms and mitigate daytime PTSD symptoms. Recently, attention has focused on the role of integrated and sequential approaches, suggesting that comprehensively treating sleep disturbances in PTSD is likely to require novel treatment modalities.
Evidence is growing on the development, course, and treatment of comorbid sleep disturbances in PTSD. Further, interventions targeting sleep disturbances in PTSD show promise in reducing symptoms. However, longitudinal investigations and additional rigorous controlled trials with diverse populations are needed to identify key features associated with treatment response in order to alleviate symptoms.
睡眠障碍，尤其是失眠和反复出现的噩梦，是创伤后应激障碍（PTSD）最常被提及的症状之一。本综述总结了PTSD中睡眠障碍的患病率估计及方法学挑战，强调了针对PTSD中共病睡眠障碍的经验证有效的心理治疗和药物干预的最新证据，并总结了改善PTSD中共病睡眠障碍的综合和序贯治疗方法的最新发现。
失眠、反复出现噩梦及其他睡眠障碍在PTSD患者中很常见；然而，一些方法学挑战导致患病率估计存在差异。有针对性的以睡眠为重点的治疗干预可改善睡眠症状并减轻日间PTSD症状。最近，人们关注综合和序贯方法的作用，这表明全面治疗PTSD中的睡眠障碍可能需要新的治疗模式。
关于PTSD中共病睡眠障碍的发生、病程和治疗的证据越来越多。此外，针对PTSD中睡眠障碍的干预措施在减轻症状方面显示出前景。然而，需要进行纵向调查和更多针对不同人群的严格对照试验，以确定与治疗反应相关的关键特征，从而缓解症状。
