Malek Nadia, Santistevan Anthony, Yack Leslie M, Kovnick Miles, Pracar Shane, Berg Emily, Metzler Thomas J, Woodward Steven H, Neylan Thomas C, Richards Anne
San Francisco VA Health Care System, San Francisco, California, USA.
Psychology Department, Arizona State University, Tempe, Arizona, USA.
J Sleep Res. 2025 Apr 3:e70054. doi: 10.1111/jsr.70054.
Posttraumatic stress disorder (PTSD) is a debilitating psychiatric condition that affects approximately 6% of the US population, with even higher rates among veterans. Sleep disturbances (e.g., distressing dreams) are among the most reported symptoms in individuals with PTSD. Distressing dreams (sometimes referred to as nightmares) have been associated with significant negative mental health outcomes, such as suicide. Therefore, understanding factors that contribute to or mitigate the risk of experiencing distressing dreams is critical for improving mental health in people with PTSD. The current study uses data on twice daily mood ratings from a mobile phone application across 3 weeks of follow-up to assess the bidirectional relationship between mood and distressing dreams. Additionally, we investigate how emotion regulation difficulties contribute to the incidence of distressing dreams and to their impact on overall mood. Participants were veterans (N = 90) and civilians (N = 13) enrolled as part of a larger study of distressing dream physiology in trauma-exposed individuals. Our results suggest that among individuals with poor mood before bed, the risk of having at least one distressing dream increases, resulting in poor mood the following morning. This negative mood state carried over into the evening on the next day, thereby further increasing the risk of having another distressing dream. Adjusting for sex, age and PTSD severity, we find that individuals with better emotion regulation have a lower incidence of distressing dreams and better mood on average. Future research on novel interventions targeting emotion regulation, mood and/or sleep disturbances is warranted.
创伤后应激障碍（PTSD）是一种使人衰弱的精神疾病，影响着约6%的美国人口，在退伍军人中的发病率更高。睡眠障碍（如痛苦的梦境）是PTSD患者中报告最多的症状之一。痛苦的梦境（有时被称为噩梦）与显著的负面心理健康结果相关，如自杀。因此，了解导致或减轻痛苦梦境风险的因素对于改善PTSD患者的心理健康至关重要。本研究使用一款手机应用程序在3周随访期间每日两次的情绪评分数据，以评估情绪与痛苦梦境之间的双向关系。此外，我们还研究了情绪调节困难如何导致痛苦梦境的发生及其对整体情绪的影响。参与者为退伍军人（N = 90）和平民（N = 13），他们作为创伤暴露个体痛苦梦境生理学更大规模研究的一部分被招募。我们的结果表明，在睡前情绪不佳的个体中，至少做一次痛苦梦境的风险会增加，导致次日早晨情绪不佳。这种负面情绪状态会延续到第二天晚上，从而进一步增加做另一个痛苦梦境的风险。在对性别、年龄和PTSD严重程度进行调整后，我们发现情绪调节能力较好的个体痛苦梦境的发生率较低，平均情绪也较好。有必要针对情绪调节、情绪和/或睡眠障碍开展新干预措施的未来研究。
