Recent Advancements in Treating Sleep Disorders in Co-Occurring PTSD

被引:86
作者
Colvonen, Peter J. [1 ,2 ,3 ]
Straus, Laura D. [4 ,5 ]
Stepnowsky, Carl [1 ,6 ]
McCarthy, Michael J. [1 ,3 ]
Goldstein, Lizabeth A. [4 ,5 ]
Norman, Sonya B. [1 ,2 ,3 ,7 ]
机构
[1] Univ Calif San Diego, VA San Diego Healthcare Syst, 3350 La Jolla Village Dr 116B, San Diego, CA 92161 USA
[2] Univ Calif San Diego, Ctr Excellence Stress & Mental Hlth, San Diego, CA 92103 USA
[3] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA
[4] San Francisco VA Healthcare Syst, Sierra Pacific Mental Illness Res Educ & Clin Ctr, San Francisco, CA USA
[5] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA USA
[6] Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA
[7] Natl Ctr PTSD, Boston, MA USA
关键词
PTSD; Sleep disorders; Insomnia; Obstructive sleep apnea; Treatment; POSTTRAUMATIC-STRESS-DISORDER; COGNITIVE-BEHAVIORAL THERAPY; POSITIVE AIRWAY PRESSURE; CLINICAL-PRACTICE GUIDELINE; PROLONGED EXPOSURE THERAPY; IMAGERY REHEARSAL THERAPY; MILITARY-RELATED PTSD; COMBAT-RELATED PTSD; PSYCHIATRIC-DISORDERS; PROCESSING THERAPY;
D O I
10.1007/s11920-018-0916-9
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Purpose of Review Comorbidity of posttraumatic stress disorder (PTSD) and insomnia, nightmares, and obstructive sleep apnea (OSA) is high. We review recent research on psychotherapeutic and pharmacological interventions for sleep disorders in PTSD. Recent Findings PTSD treatments decrease PTSD severity and nightmare frequency, but do not resolve OSA or insomnia. Research on whether insomnia hinders PTSD treatment shows mixed results; untreated OSA does interfere with PTSD treatment. Cognitive behavioral therapy for insomnia is the recommended treatment for insomnia; however, optimal ordering with PTSD treatment is unclear. PTSD treatment may be most useful for PTSD-related nightmares. CPAP therapy is recommended for OSA but adherence can be low. Summary Targeted treatment of sleep disorders in the context of PTSD offers a unique and underutilized opportunity to advance clinical care and research. Research is needed to create screening protocols, determine optimal order of treatment, and elucidate mechanisms between sleep and PTSD treatments.
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页数:13
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