Mendoza Alvarez Mariana, Balthasar Yannick, Verbraecken Johan, Claes Laurence, van Someren Eus, van Marle Hein J F, Vandekerckhove Marie, De Picker Livia
Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610, Antwerp, Belgium; Scientific Initiative of Neuropsychiatric and Psychopharmacological Studies (SINAPS), University Psychiatric Hospital Campus Duffel, Rooienberg 19, 2570, Duffel, Belgium.
Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610, Antwerp, Belgium.
Sleep Med. 2025 Mar;127:1-15. doi: 10.1016/j.sleep.2024.12.037. Epub 2024 Dec 31.
Fragmented rapid eye movement (REM) sleep disrupts the overnight resolution of emotional distress, a process crucial for emotion regulation. Emotion dysregulation, which is common across psychiatric disorders, is often associated with sleep disturbances. This systematic review explores how REM sleep and nightmares affect emotion processing and regulation in individuals with psychiatric disorders where emotion dysregulation is a key concern, suggesting novel sleep-related treatment pathways.
We performed a PRISMA-compliant systematic search of the PUBMED, Web of Science, and EBSCO databases from January 1994-February 2023. This systematic review targeted studies on REM sleep, nightmares, and emotion regulation in a postpubescent clinical population with affective dysregulation. The quality of the studies was assessed via the Newcastle‒Ottawa Scale (NOS), adapted for cross-sectional studies.
From the 714 screened records, 28 articles met the inclusion criteria and focused on REM sleep, dreams, or nightmares in individuals with mood disorders (k = 8), anxiety disorders (k = 1), posttraumatic stress disorder (PTSD) (k = 16), non-suicidal self-injury (NSSI), personality disorders (k = 2), and autism (k = 1). Fifteen studies used objective sleep measures, seventeen used self-reported assessments, six included treatment components, eight investigated nightmares, and three examined dreams. NOS scores ranged from moderate to high.
REM sleep disturbances represent a transdiagnostic feature across psychiatric disorders and are crucial for emotion regulation. Nightmares are associated with suicidal behaviour and emotion dysregulation. Targeted sleep interventions may improve emotion regulation and mental health outcomes. Future research should explore the role of REM sleep in disorder prognosis to develop tailored interventions.
快速眼动（REM）睡眠碎片化会破坏夜间情绪困扰的缓解，而这一过程对情绪调节至关重要。情绪调节障碍在各种精神疾病中都很常见，且常常与睡眠障碍相关。本系统评价探讨了REM睡眠和噩梦如何影响情绪调节障碍为关键问题的精神疾病患者的情绪处理和调节，提出了与睡眠相关的新治疗途径。
我们按照PRISMA标准对1994年1月至2023年2月期间的PUBMED、科学网和EBSCO数据库进行了系统检索。本系统评价针对青春期后情感调节障碍临床人群中关于REM睡眠、噩梦和情绪调节的研究。研究质量通过适用于横断面研究的纽卡斯尔-渥太华量表（NOS）进行评估。
在筛选出的714条记录中，28篇文章符合纳入标准，重点关注情绪障碍（k = 8）、焦虑症（k = 1）、创伤后应激障碍（PTSD）（k = 十六）、非自杀性自伤（NSSI）、人格障碍（k = 2）和自闭症（k = 1）患者的REM睡眠、梦境或噩梦。15项研究使用了客观睡眠测量方法，17项使用了自我报告评估，6项包括治疗成分，8项调查了噩梦，3项研究了梦境。NOS评分从中等到高。
REM睡眠障碍是各种精神疾病的一种跨诊断特征，对情绪调节至关重要。噩梦与自杀行为和情绪调节障碍有关。有针对性的睡眠干预可能会改善情绪调节和心理健康结果。未来的研究应探索REM睡眠在疾病预后中的作用，以制定针对性的干预措施。
