Competence Centre for Transcultural Psychiatry, Mental Health Center Ballerup, Mental Health Services in the Capital Region of Denmark, Ballerup, Denmark.
Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Sleep. 2021 Sep 13;44(9). doi: 10.1093/sleep/zsab063.
To examine whether baseline sleep quality is associated with baseline symptoms of posttraumatic stress disorder (PTSD) and level of functioning and whether baseline sleep quality and improvement of sleep quality are specific predictors of change in PTSD symptoms and level of functioning.
Data were derived from a four-armed randomized controlled superiority trial (N = 219 trauma-affected refugees). All four groups received treatment as usual consisting of a 10-12 months bio-psycho-social treatment program with an additional differential treatment component added to each arm. We performed bivariate correlation analyses, multiple linear regression analyses, and mediation analyses to examine associations between baseline sleep quality, change in sleep quality, and treatment response for PTSD symptoms and level of functioning.
Baseline sleep quality correlated with symptoms of PTSD (r = 0.33) and level of functioning (r = 0.15). Baseline sleep quality, improvement of sleep quality, and improvement of general well-being were predictors of treatment response for symptoms of PTSD and level of functioning when controlling for age, gender, and baseline symptoms of PTSD and depression.
We found that good sleep quality at baseline and improvement of sleep quality were predictors of PTSD treatment response. However, treatment response was more closely associated with improvement in general well-being. The results indicate that the effect of improved sleep quality was partly mediated by a more general mental state improvement. Further research is needed to differentiate if a selected subgroup of patients may profit from sleep-enhancing treatment.
CLINICALTRIALS.GOV REGISTRATION: NCT02761161.
考察基线睡眠质量是否与创伤后应激障碍（PTSD）的基线症状和功能水平有关，以及基线睡眠质量和睡眠质量的改善是否是 PTSD 症状和功能水平变化的特定预测指标。
数据来自一项四臂随机对照优势试验（N=219 名受创伤影响的难民）。所有四组均接受常规治疗，包括为期 10-12 个月的生物心理社会治疗方案，并在每个手臂中添加额外的差异治疗成分。我们进行了双变量相关分析、多元线性回归分析和中介分析，以检查基线睡眠质量、睡眠质量变化与 PTSD 症状和功能水平治疗反应之间的关联。
基线睡眠质量与 PTSD 症状（r=0.33）和功能水平（r=0.15）相关。基线睡眠质量、睡眠质量改善和一般幸福感改善是 PTSD 症状和功能水平治疗反应的预测指标，在控制年龄、性别以及 PTSD 和抑郁的基线症状后。
我们发现基线睡眠质量好和睡眠质量改善是 PTSD 治疗反应的预测指标。然而，治疗反应与一般幸福感的改善更为密切相关。结果表明，睡眠质量改善的效果部分是通过更普遍的精神状态改善来介导的。需要进一步研究来区分是否有一个特定的患者亚组可能受益于增强睡眠的治疗。
NCT02761161。
