Brion Agnès
Psychiatre, spécialiste des troubles du sommeil et de la vigilance, vice-présidente du réseau Morphée, Paris, France.
Rev Prat. 2021 Nov;71(9):1001-1006.
Practice guide for The management of nightmare Disorders Nightmares are a common parasomnia that occurs mainly During rem sleep (paradoxical sleep) and at all ages. Recurrent nightmares, also known as nightmare disorder, Are considered a clinical entity and cause significant Suffering. Other parasomnias presenting dysphoric dreams Or fragments of dreams are to be distinguished from Nightmares and their management is different: they are Mainly night terror, hallucinations related to sleep and Rem sleep behavior disorder. Nightmares can be idiopathic Or comorbid; they are more common in the context Of stress or trauma and in people with high levels of Anxiety. The clinical assessment primarily looks for psychopathology, But also for another sleep disorder that can Promote the onset of nightmares (narcolepsy, obstructive Sleep apnea syndrome) and an iatrogenic or toxic origin; Rarely nocturnal epilepsy is involved. The treatment of Recurrent nightmares is primarily psychotherapeutic, and The imagery rehearsal therapy (irt) is recommended for Its effectiveness for both idiopathic nightmares and those Related to post-traumatic stress disorder.
梦魇障碍管理实践指南 梦魇是一种常见的异态睡眠，主要发生在快速眼动睡眠（异相睡眠）期，各个年龄段均可出现。反复出现的梦魇，也称为梦魇障碍，被视为一种临床病症，会造成巨大痛苦。其他表现为烦躁不安梦境或梦的片段的异态睡眠应与梦魇相区分，其管理方式也有所不同：主要包括夜惊、与睡眠相关的幻觉和快速眼动睡眠行为障碍。梦魇可以是特发性的或共病性的；在压力或创伤情境以及焦虑水平较高的人群中更为常见。临床评估主要寻找精神病理学因素，但也要寻找可能促发梦魇的其他睡眠障碍（发作性睡病、阻塞性睡眠呼吸暂停综合征）以及医源性或中毒性病因；极少涉及夜间癫痫。反复梦魇的治疗主要是心理治疗，意象再演练疗法（IRT）因其对特发性梦魇和与创伤后应激障碍相关的梦魇均有效而被推荐。
