ABSTRACT

Background: Most posttraumatic stress disorder (PTSD) sleep disturbances reports have been conducted in male combat veteran populations, usually decades after the disorder’s onset. Given the increase in the prevalence of violence against women and the fact that women are at greater risk for developing PTSD, it is critical to examine sleep abnormalities in this population.

Objectives: To examine subjective and objective sleep quality in young women with PTSD following sexual assault compared with a control group at baseline and after one year of treatment.

Methods: Seventy-four women with PTSD following sexual assault and 64 healthy controls with no history of sexual assault were assessed using the Clinician-Administered PTSD Scale (CAPS-5), the Beck Depression Inventory, the Beck Anxiety Inventory, the Pittsburgh Sleep Quality Index (PSQI), the Modified Fatigue Impact Scale, and the Insomnia Severity Index. Subjects also underwent full in-lab polysomnography. PTSD participants received pharmacological and/or psychological therapy between baseline and one-year follow-up.

Results: The PTSD group had significantly higher scores in the clinical and sleep measurements than the control group. Although the PTSD group reported poorer subjective sleep quality than healthy controls, there were few between-group differences in objective sleep. Analysis of the PTSD group at baseline and one-year follow-up showed that the PSQI global score was a significant predictor of PTSD improvement.

Conclusions: Sleep quality is impaired in young women with PTSD and may impact long-term treatment responses. Better sleep quality is significantly associated with PTSD improvement, independent of depression and anxiety.

摘要

背景：大多数创伤后应激障碍 (PTSD) 睡眠障碍报告是在男性退伍军人人群中进行的，通常是在疾病发作后数十年。鉴于对女性的暴力行为越来越普遍，而且女性患创伤后应激障碍的风险更大，因此检查这一人群的睡眠异常至关重要。

目标：与对照组相比，在基线和治疗一年后，检查性侵犯后患有 PTSD 的年轻女性的主观和客观睡眠质量。

方法：使用临床医生管理的 PTSD 量表 (CAPS-5)、贝克抑郁量表、贝克焦虑量表、匹兹堡睡眠质量评估 74 名性侵犯后患有 PTSD 的女性和 64 名没有性侵犯史的健康对照者指数 (PSQI)、改良疲劳影响量表和失眠严重程度指数。受试者还接受了全面的实验室内多导睡眠监测。PTSD 参与者在基线和一年随访期间接受了药物和/或心理治疗。

结果：PTSD 组在临床和睡眠测量方面的得分明显高于对照组。尽管 PTSD 组报告的主观睡眠质量比健康对照组差，但客观睡眠方面的组间差异很小。对基线和一年随访时 PTSD 组的分析表明，PSQI 总体评分是 PTSD 改善的重要预测指标。

结论：患有 PTSD 的年轻女性的睡眠质量受损，并可能影响长期治疗反应。更好的睡眠质量与 PTSD 的改善显着相关，与抑郁和焦虑无关。