Onton Julie, Le Lu D
Institute for Neural Computation, University of California San Diego, 9500 Gilman Drive, #0523, La Jolla, CA, 92093, USA.
Veterans Affairs San Diego Healthcare System, ASPIRE Center, 2121 San Diego Avenue, San Diego, CA, 92110, USA.
Neurobiol Sleep Circadian Rhythms. 2021 Jul 16;11:100072. doi: 10.1016/j.nbscr.2021.100072. eCollection 2021 Nov.
Military veterans with posttraumatic stress disorder often complain of non-restful sleep, which further exacerbates their symptoms. Our previous study showed a deficit in Lo Deep sleep, or slow oscillations, in the PTSD population compared to healthy control sleepers. Because Lo Deep sleep is likely a stage when the brain eliminates protein debris, it is critical to find the cause and effective therapeutics to reverse Lo Deep deficiency. The current study aims to replicate and extend this finding by examining several physiological and medication factors that may be responsible for the Lo Deep deficiency. We recorded overnight sleep electroencephalogram (EEG) via a 2-channel headband device on 69 veterans in a residential treatment facility. Dried urine samples were collected at 4 time points during one day to measure melatonin, cortisol, norepinephrine and other factors. EEG data were transformed into frequency power and submitted to an automated sleep scoring algorithm. The scoring corresponds to clear spectral patterns in the overnight spectrogram but does not align exactly with traditional visual scoring stages. As expected veterans showed decreased Lo Deep (activity < 1 Hz) and more Hi Deep sleep (1-3 Hz activity) than healthy controls, replicating our previous study. Multiple linear regressions showed that melatonin dose and morning urine melatonin correlated with more Lo Deep sleep. Buspirone dose also correlated with more Lo Deep, but only 6 subjects were taking buspirone. Also replicating the findings from our last study were independent reductions of REM sleep with prazosin and sertraline. Other findings included decreased Lo and increased Hi Deep sleep with higher caffeine dose, and less Hi Deep percentage with higher testosterone. Finally, evening cortisol levels correlated with a higher percentage of Wake after sleep onset. These results confirm Lo Deep deficiency in this PTSD population and suggests melatonin as a possible therapeutic to reverse Lo Deep deficiency. This is a critical first step to establishing a systematic sleep assessment and treatment program in this and potentially other populations to prevent future brain pathology.
患有创伤后应激障碍的退伍军人经常抱怨睡眠不安稳，这进一步加剧了他们的症状。我们之前的研究表明，与健康对照者相比，创伤后应激障碍患者的低深度睡眠（即慢波振荡）存在缺陷。由于低深度睡眠可能是大脑清除蛋白质碎片的阶段，因此找出导致低深度睡眠不足的原因并找到有效的治疗方法来扭转这种不足至关重要。当前的研究旨在通过检查可能导致低深度睡眠不足的几个生理和药物因素来复制和扩展这一发现。我们通过一个双通道头带设备，对一家住院治疗机构中的69名退伍军人进行了夜间睡眠脑电图（EEG）记录。在一天中的4个时间点收集干燥的尿液样本，以测量褪黑素、皮质醇、去甲肾上腺素和其他因素。EEG数据被转换为频率功率，并提交给一种自动睡眠评分算法。该评分对应于夜间频谱图中清晰的频谱模式，但与传统的视觉评分阶段并不完全一致。正如预期的那样，与健康对照者相比，退伍军人表现出低深度睡眠减少（活动频率<1赫兹）和高深度睡眠（1 - 3赫兹活动）增多，这复制了我们之前的研究。多元线性回归显示，褪黑素剂量和晨尿褪黑素与更多的低深度睡眠相关。丁螺环酮剂量也与更多的低深度睡眠相关，但只有6名受试者服用丁螺环酮。哌唑嗪和舍曲林使快速眼动睡眠独立减少，这也复制了我们上一项研究的结果。其他发现包括，咖啡因剂量越高，低深度睡眠减少、高深度睡眠增加，而睾酮水平越高，高深度睡眠百分比越低。最后，夜间皮质醇水平与睡眠开始后较高的觉醒百分比相关。这些结果证实了该创伤后应激障碍人群存在低深度睡眠不足，并表明褪黑素可能是扭转低深度睡眠不足的一种治疗方法。这是在该人群以及可能的其他人群中建立系统的睡眠评估和治疗方案以预防未来脑部病变的关键第一步。
