Ferrara Michele, Mazza Monica, Curcio Giuseppe, Iaria Giuseppe, De Gennaro Luigi, Tempesta Daniela
Dipartimento di scienze cliniche applicate e biotecnologiche, Università dell'Aquila.
Dipartimento di medicina clinica, sanità pubblica, scienze della vita e dell'ambiente, Università dell'Aquila.
Epidemiol Prev. 2016 Mar-Apr;40(2 Suppl 1):45-8. doi: 10.19191/EP16.2S1.P045.047.
Altered sleep is a common and central symptom of post-traumatic stress disorder (PTSD). In fact, sleep disturbances are included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for PTSD. However, it has been hypothesized that sleep disturbances are crucially involved in the aetiology of PTSD, rather than being solely a symptom arising secondarily from this disorder. Therefore, knowing the long-term effects of a trauma can be essential to establish the need of specific interventions for the prevention and treatment of mental disorders that may persist years after a traumatic experience. In one study we showed, for the first time, that even after a period of two years people exposed to a catastrophic disaster such as the L'Aquila earthquake continue to suffer from a reduced sleep quality. Moreover, we observed that sleep quality scores decreased as a function of the proximity to the epicentre, suggesting that the psychological effects of an earthquake may be pervasive and long-lasting. It has been widely shown that disruption of sleep by acute stress may lead to deterioration in memory processing. In fact, in a recent study we observed alterations in spatial memory in PTSD subjects. Our findings indicated that PTSD is accompanied by an impressive deficit in forming a cognitive map of the environment, as well as in sleep-dependent memory consolidation. The fact that this deterioration was correlated to the subjective sleep disturbances in our PTSD group demonstrates the existence of an intimate relationship between sleep, memory consolidation, and stress.
睡眠改变是创伤后应激障碍(PTSD)常见且核心的症状。事实上,睡眠障碍被纳入了《精神疾病诊断与统计手册》第五版(DSM-5)中PTSD的诊断标准。然而,有假设认为睡眠障碍在PTSD的病因学中起关键作用,而非仅仅是该疾病继发产生的一种症状。因此,了解创伤的长期影响对于确定是否需要针对可能在创伤经历数年后仍持续存在的精神障碍进行预防和治疗的特定干预措施至关重要。在一项研究中,我们首次表明,即使在两年后,经历过像拉奎拉地震这样的灾难性事件的人仍持续存在睡眠质量下降的情况。此外,我们观察到睡眠质量得分随着与震中的距离增加而降低,这表明地震的心理影响可能是广泛且持久的。已有广泛研究表明,急性应激导致的睡眠中断可能会使记忆处理能力恶化。事实上,在最近的一项研究中,我们观察到PTSD患者的空间记忆出现了改变。我们的研究结果表明,PTSD患者在形成环境认知地图以及依赖睡眠的记忆巩固方面存在明显缺陷。在我们的PTSD组中,这种记忆恶化与主观睡眠障碍相关,这一事实证明了睡眠、记忆巩固和应激之间存在密切关系。