Department of Psychology, Ludwig-Maximilians-University Munich.
Psychol Trauma. 2024 Jul;16(5):846-854. doi: 10.1037/tra0001386. Epub 2022 Dec 1.
There is robust evidence for the influence of sleep disturbances on the maintenance of PTSD symptoms. However, little is known about day-to-day variation in trauma-related sleep disturbances (namely insomnia symptoms and nightmares) and their associations with PTSD symptoms. Therefore, we explored the dynamic interplay of these symptoms in daily life using an experience sampling method (ESM).
For 15 consecutive days, participants with PTSD symptomatology as primary complaint ( = 48) reported momentary levels of insomnia symptoms and nightmares as well as PTSD symptoms via a mobile app.
Multilevel model analyses revealed that insomnia and nightmares were significant predictors of PTSD symptomatology on the following day; furthermore, nightmares were predictive of each of the four PTSD symptom clusters, namely reexperiencing, avoidance, cognition and hyperarousal as well as symptoms of dissociation. However, PTSD symptoms did not predict insomnia or nightmares during the following night. Multilevel mediation analyses suggested that nightmares mediate the relationship between insomnia and next-day PTSD symptoms.
These findings support accumulating evidence that trauma-related sleep disturbances play an important role in the maintenance of PTSD symptoms, by elevating symptoms daily. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
有大量证据表明睡眠障碍会影响 PTSD 症状的维持。然而，对于创伤相关睡眠障碍（即失眠症状和噩梦）的日常变化及其与 PTSD 症状的关系知之甚少。因此，我们使用经验抽样法（ESM）探讨了这些症状在日常生活中的动态相互作用。
在连续 15 天内，以 PTSD 症状为主要主诉的参与者（=48 人）通过移动应用程序报告了失眠症状和噩梦以及 PTSD 症状的瞬间水平。
多层次模型分析显示，失眠和噩梦是次日 PTSD 症状的显著预测因素；此外，噩梦可预测四个 PTSD 症状群中的每一个，即再体验、回避、认知和警觉过度以及分离症状。然而，PTSD 症状并不能预测接下来的夜晚的失眠或噩梦。多层次中介分析表明，噩梦中介了失眠与次日 PTSD 症状之间的关系。
这些发现支持了越来越多的证据，即创伤相关的睡眠障碍通过每天加重症状，在 PTSD 症状的维持中起着重要作用。（PsycInfo 数据库记录（c）2024 APA，保留所有权利）。
