Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany; Leibniz Institute for Resilience Research (LIR), Mainz, Germany; Technische Universität Braunschweig, Department of Clinical Psychology, Psychotherapy and Psychodiagnostics, Brunswick, Germany.
Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany.
Behav Res Ther. 2023 Aug;167:104359. doi: 10.1016/j.brat.2023.104359. Epub 2023 Jun 28.
Distressing intrusive memories of a traumatic event are one of the hallmark symptoms of posttraumatic stress disorder. Thus, it is crucial to identify early interventions that prevent the occurrence of intrusive memories. Both, sleep and sleep deprivation have been discussed as such interventions, yet previous studies yielded contradicting effects. Our systematic review aims at evaluating existing evidence by means of traditional and individual participant data (IPD) meta-analyses to overcome power issues of sleep research. Until May 16, 2022, six databases were searched for experimental analog studies examining the effect of post-trauma sleep versus wakefulness on intrusive memories. Nine studies were included in our traditional meta-analysis (8 in the IPD meta-analysis). Our analysis provided evidence for a small effect favoring sleep over wakefulness, log-ROM = 0.25, p < .001, suggesting that sleep is associated with a lower number of intrusions but unrelated to the occurrence of any versus no intrusions. We found no evidence for an effect of sleep on intrusion distress. Heterogeneity was low and certainty of evidence for our primary analysis was moderate. Our findings suggest that post-trauma sleep has the potential to be protective by reducing intrusion frequency. More research is needed to determine the impact following real-world trauma and the potential clinical significance.
创伤后事件的痛苦侵入性记忆是创伤后应激障碍的标志性症状之一。因此，确定预防侵入性记忆发生的早期干预措施至关重要。睡眠和睡眠剥夺都被认为是这种干预措施，但以前的研究结果却存在矛盾。我们的系统评价旨在通过传统和个体参与者数据（IPD）荟萃分析来评估现有证据，以克服睡眠研究的效力问题。截至 2022 年 5 月 16 日，我们在六个数据库中搜索了实验模拟研究，以检验创伤后睡眠与清醒对侵入性记忆的影响。我们的传统荟萃分析纳入了九项研究（IPD 荟萃分析中纳入了八项研究）。我们的分析提供了证据表明，与清醒相比，睡眠有利于降低侵入性记忆，log-ROM=0.25，p<0.001，这表明睡眠与侵入性记忆的频率较低有关，而与是否存在侵入性记忆无关。我们没有发现睡眠对侵入性记忆困扰有影响的证据。异质性较低，我们的主要分析证据的确定性为中等。我们的研究结果表明，创伤后睡眠具有通过降低侵入性记忆频率来提供保护的潜力。需要更多的研究来确定真实创伤后的影响和潜在的临床意义。
