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Travma sonrası stres bozukluğu hastalarında gece idrar noradrenalin düzeyleri ve uyku yapısı

Nocturnal levels of urinary noradrenaline and sleep structure in patients with post-traumatic stress disorder

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Abstract (2. Language): 
Noradrenergic system is one of the major central nervous system effectors of the human stress response. The studies suggest that the patients with post-traumatic stress disorder have hyperreactive noradrenergic systems, and this exaggerated noradrenergic activity is associated with a number of hyperarousal symptoms in post-traumatic stress disorder. Central noradrenergic system also has a role in the regulation of arousal state during sleep. In this study, it was therefore aimed to investigate the relationship between nocturnal urinary levels of noradrenaline and sleep variables. Fourteen patients with chronic post-traumatic stress disorder and 12 age- and sex-matched healthy normal controls were investigated with polysomnographic recordings on two consecutive nights. Urine samples were collected for 24 hours in three 8-hour collections following the adaptation night in the sleep laboratory. Patients with post-traumatic stress disorder had difficulty in initiating sleep, poor sleep efficiency, decreased total sleep time, decreased slow wave sleep, and a reduced rapid eye movement sleep latency when compared to the normal controls. There was not any correlation between nocturnal urinary noradrenaline values and sleep variables. This study did not demonstrate any significant relationship between urinary noradrenaline levels and disturbed sleep measures in patients with posttraumatic stress disorder.
Abstract (Original Language): 
Noradrenerjik sistem, stres cevabının önemli merkezi sinir sistemi yolaklarından birisidir. Çalışmalar travma sonrası stres bozukluğu hastalarında noradrenerjik sistemin aşırı aktivite gösterdiğini ve bu aşırı noradrenerjik aktivitenin aşırı uyarılmışlık bulguları ile ilişkili olduğunu desteklemektedir. Merkezi noradrenerjik sistem aynı zamanda uykuda uyarılmışlığın düzenlenmesinde rol alır. Çalışmada, bu nedenle gece idrar noradrenalin ölçümleri ile uyku de- ğişkenleri arasındaki ilişkiyi araştırmak amaçlanmıştır. On dört kronik travma sonrası stres bozukluğu hastası ile yaş ve cinsiyet yönünden eşleştirilmiş 12 sağlıklı normal kontrol vakası ardışık 2 gece polisomnografi çalışması ile incelenmiştir. Adaptasyon gecesini takiben yirmi dört saatlik idrar sekizer saatlik kaplarla uyku laboratuvarında toplanmıştır. Normal kontrol grubu ile karşılaştırıldığında travma sonrası stres bozukluğu hastalarında uykuya baş- lamakta güçlük, uyku etkinliğinde, toplam uyku süresinde, yavaş dalga uykusunda azalma ve REM uyku latensinde azalma gözlendi. Uyku değişkenleri ile gece idrar noradrenalin düzeyleri arasındaki ilişki incelendiğinde ise herhangi bir bağıntı bulunmadı. Bu çalışmada travma sonrası stres bozukluğu hastalarında idrar örneklerinden alınan noradrenalin değerleri ile bozulmuş uyku değerleri arasında herhangi bir ilişki gösterilememiştir.
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