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张烨, 任蓉, 杨玲慧, 等. 创伤后应激障碍与睡眠障碍[J]. 四川大学学报(医学版), 2021, 52(1): 28-32. DOI: 10.12182/20210160201
引用本文: 张烨, 任蓉, 杨玲慧, 等. 创伤后应激障碍与睡眠障碍[J]. 四川大学学报(医学版), 2021, 52(1): 28-32. DOI: 10.12182/20210160201
ZHANG Ye, REN Rong, YANG Ling-hui, et al. A Review of the Posttraumatic Stress Disorder and Sleep Disturbances[J]. Journal of Sichuan University (Medical Sciences), 2021, 52(1): 28-32. DOI: 10.12182/20210160201
Citation: ZHANG Ye, REN Rong, YANG Ling-hui, et al. A Review of the Posttraumatic Stress Disorder and Sleep Disturbances[J]. Journal of Sichuan University (Medical Sciences), 2021, 52(1): 28-32. DOI: 10.12182/20210160201

创伤后应激障碍与睡眠障碍

A Review of the Posttraumatic Stress Disorder and Sleep Disturbances

  • 摘要: 创伤后应激障碍(PTSD)是个体经历一个或多个创伤事件后出现的一种以闯入性创伤情感记忆、高警觉性和回避为主要临床表现的精神障碍。除了上述临床表现外,睡眠障碍也是PTSD的核心症状之一。本文主要围绕失眠、夜间梦魇、阻塞性睡眠呼吸暂停(OSA)及周期性肢体运动四方面探讨PTSD相关睡眠障碍的临床研究现状。失眠是PTSD发生发展的有效预测因素,失眠的认知行为治疗是PTSD患者失眠治疗的重要研究方向。夜间梦魇是PTSD的核心症状之一,哌唑嗪及意象排演治疗是治疗创伤后梦魇的有效方法。PTSD患者中OSA共病率超过40%。初步研究表明持续气道正压通气治疗有助于改善共病者PTSD症状。对PTSD患者进行临床诊疗的过程中,应注重首先评估PTSD患者是否罹患失眠、OSA等睡眠障碍,再进一步明确患者的临床治疗方案。

     

    Abstract: Post-traumatic stress disorder (PTSD) is characterized by intrusive emotional memory, alertness and avoidance after individuals suffer from one or more traumatic events. With the exception of manifestations, sleep disturbances are also considered to be the core symptoms of PTSD. This article mainly discussed insomnia, nightmares, obstructive sleep apnea (OSA), and periodic limb movement during sleep (PLMS) in patients with PTSD. Existing evidence suggested that insomnia is a predictor of the development of PTSD. Cognitive behavioral therapy for insomnia is an important research direction for treating insomnia in PTSD patients. Nightmares are also the core symptom of PTSD. Prazosin and image rehearsal therapy are effective therapies to treat post-traumatic nightmares. The co-occurrence of obstructive sleep apnea (OSA) is over 40% in patients with PTSD. Preliminary studies have shown that continuous positive airway pressure therapy can improve PTSD symptoms in patients with PTSD comorbid OSA. In the process of diagnosis and treatment of PTSD patients, it is important to firstly evaluate whether PTSD patient comorbid OSA or insomnia, and then clinicians could further develop an appropriate treatment plan for these patients.

     

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