Vanek Jakub, Prasko Jan, Ociskova Marie, Hodny Frantisek, Holubova Michaela, Minarikova Kamila, Slepecky Milos, Nesnidal Vlastimil
Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, 77520, The Czech Republic.
Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic.
Nat Sci Sleep. 2021 Feb 22;13:239-250. doi: 10.2147/NSS.S295030. eCollection 2021.
Both sleep disorders and BPD are prevalent in the population, and one is often a comorbidity of the other. This narrative review aims to assess contemporary literature and scientific databases to provide the current state of knowledge about sleep disorders in patients with borderline personality disorder (BPD) and clinical suggestions for managing sleep disorders in BPD patients and future research direction.
Articles were acquired via PubMed and Web of Science, and papers published between January 1980 and October 2020 were extracted. Authors made a series of literature searches using the keywords: Sleep problems, Insomnia, Nightmares, Obstructive sleep apnea, Borderline personality disorder. The inclusion criteria were: published in peer-reviewed journals; studies in humans; or reviews on the related topic; English language. The exclusion criteria were: abstracts from conferences; commentaries; subjects younger than 18 years. After an inspection of the full texts, 42 papers from 101 were selected. Secondary documents from the reference lists of the primary designated papers were searched, assessed for suitability, and included. In total, 71 papers were included in the review process.
Sleep disturbance is common among patients with BPD. Nevertheless, the number of investigations is limited, and the prevalence differs between 5-45%. Studies assessing objective changes in sleep architecture in BPD show inconsistent results. Some of them identify REM sleep changes and a decrease in slow-wave sleep, while other studies found no objective sleep architecture changes. There is also a higher prevalence of nightmares in patients with BPD. Untreated insomnia can worsen BPD symptoms via interference with emotional regulation. BPD itself seems to influence the subjective quality of sleep significantly. Proper diagnosis and treatment of sleep disorders in patients with BPD could lead to better results in therapy. Psychotherapeutic approaches can improve both sleep disorders and BPD symptoms.
Recognising and managing sleep disorders in patients with BPD may help alleviate the disorder's symptoms. Treatment of people with BPD may be more effective if the treatment plan explicitly addresses sleep problems. Further research is needed to reach reliable conclusions.
睡眠障碍和边缘型人格障碍（BPD）在人群中都很常见，且二者常互为共病。本叙述性综述旨在评估当代文献和科学数据库，以呈现关于边缘型人格障碍患者睡眠障碍的当前知识状态，并为管理BPD患者的睡眠障碍提供临床建议及未来研究方向。
通过PubMed和Web of Science获取文章，并提取1980年1月至2020年10月发表的论文。作者使用关键词“睡眠问题”“失眠”“噩梦”“阻塞性睡眠呼吸暂停”“边缘型人格障碍”进行了一系列文献检索。纳入标准为：发表于同行评审期刊；以人为研究对象；或相关主题的综述；英文文献。排除标准为：会议摘要；评论；研究对象年龄小于18岁。在检查全文后，从101篇论文中选取了42篇。对主要指定论文参考文献列表中的二次文献进行检索、评估其适用性并纳入。综述过程共纳入71篇论文。
睡眠障碍在BPD患者中很常见。然而，相关研究数量有限，患病率在5%至45%之间有所不同。评估BPD患者睡眠结构客观变化的研究结果不一致。其中一些研究发现快速眼动（REM）睡眠变化和慢波睡眠减少，而其他研究未发现睡眠结构的客观变化。BPD患者中噩梦的患病率也较高。未经治疗的失眠会通过干扰情绪调节加重BPD症状。BPD本身似乎对睡眠主观质量有显著影响。正确诊断和治疗BPD患者的睡眠障碍可能会使治疗效果更好。心理治疗方法可以改善睡眠障碍和BPD症状。
识别和管理BPD患者的睡眠障碍可能有助于缓解该障碍的症状。如果治疗计划明确解决睡眠问题，对BPD患者的治疗可能会更有效。需要进一步研究以得出可靠结论。
