James A. Haley Veterans' Hospital, Tampa, Florida.
Department of Psychiatry & Behavioral Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida.
J Clin Sleep Med. 2022 Jun 1;18(6):1617-1627. doi: 10.5664/jcsm.9926.
Characterize associations between sleep impairments and posttraumatic stress disorder (PTSD) symptoms, including anger, in service members seeking treatment for PTSD.
Ninety-three US Army personnel recruited into a PTSD treatment study completed the baseline assessment. State-of-the-science sleep measurements included 1) retrospective, self-reported insomnia, 2) prospective sleep diaries assessing sleep patterns and nightmares, and 3) polysomnography measured sleep architecture and obstructive sleep apnea-hypopnea severity. Dependent variables included self-report measures of PTSD severity and anger severity. Pearson correlations and multiple linear regression analyses examined if sleep symptoms, not generally measured in PTSD populations, were associated with PTSD and anger severity.
All participants met PTSD, insomnia, and nightmare diagnostic criteria. Mean sleep efficiency = 70%, total sleep time = 5.5 hours, obstructive sleep apnea/hypopnea (obstructive sleep apnea-hypopnea index ≥ 5 events/h) = 53%, and clinically significant anger = 85%. PTSD severity was associated with insomnia severity (β = .58), nightmare severity (β = .24), nightmare frequency (β = .31), and time spent in Stage 1 sleep (β = .27, all < .05). Anger severity was associated with insomnia severity (β = .37), nightmare severity (β = .28), and obstructive sleep apnea-hypopnea during rapid eye movement sleep (β = .31, all < .05).
Insomnia and nightmares were related to PTSD and anger severity, and obstructive sleep apnea-hypopnea was related to anger. Better assessment and evidence-based treatment of these comorbid sleep impairments in service members with PTSD and significant anger should result in better PTSD, anger, and quality-of-life outcomes.
Registry: ClinicalTrials.gov; Name: Treatment of Comorbid Sleep Disorders and Post Traumatic Stress Disorder; Identifier: NCT02773693; URL: https://clinicaltrials.gov/ct2/show/NCT02773693.
Miles SR, Pruiksma KE, Slavis D, et al. Sleep disorder symptoms are associated with greater posttraumatic stress and anger symptoms in US Army service members seeking treatment for posttraumatic stress disorder. . 2022;18(6):1617-1627.
描述睡眠障碍与创伤后应激障碍（PTSD）症状（包括愤怒）之间的关联，这些症状存在于寻求 PTSD 治疗的军人中。
93 名美国陆军人员被招募到 PTSD 治疗研究中，完成了基线评估。睡眠测量的科学方法包括：1）回顾性的、自我报告的失眠症；2）前瞻性的睡眠日记，评估睡眠模式和噩梦；3）多导睡眠图测量睡眠结构和阻塞性睡眠呼吸暂停低通气严重程度。因变量包括 PTSD 严重程度和愤怒严重程度的自我报告测量。皮尔逊相关和多元线性回归分析检查了一般不包括在 PTSD 人群中的睡眠症状是否与 PTSD 和愤怒严重程度有关。
所有参与者均符合 PTSD、失眠症和噩梦的诊断标准。平均睡眠效率=70%，总睡眠时间=5.5 小时，阻塞性睡眠呼吸暂停低通气（阻塞性睡眠呼吸暂停低通气指数≥5 次/小时）=53%，临床显著的愤怒=85%。PTSD 严重程度与失眠严重程度（β=0.58）、噩梦严重程度（β=0.24）、噩梦频率（β=0.31）和 Stage 1 睡眠时间（β=0.27，均<0.05）有关。愤怒严重程度与失眠严重程度（β=0.37）、噩梦严重程度（β=0.28）和快速眼动睡眠期间的阻塞性睡眠呼吸暂停低通气（β=0.31，均<0.05）有关。
失眠症和噩梦与 PTSD 和愤怒严重程度有关，阻塞性睡眠呼吸暂停低通气与愤怒有关。更好地评估和提供针对 PTSD 军人伴发的这些共病性睡眠障碍的循证治疗，应该会改善 PTSD、愤怒和生活质量的结果。
注册机构：ClinicalTrials.gov；名称：治疗共病睡眠障碍和创伤后应激障碍；标识符：NCT02773693；网址：https://clinicaltrials.gov/ct2/show/NCT02773693。
Miles SR, Pruiksma KE, Slavis D, et al. 睡眠障碍症状与寻求创伤后应激障碍治疗的美国陆军军人的创伤后应激障碍和愤怒症状更为相关。. 2022;18(6):1617-1627.
