Article record

一名青少年在辅助三己芬迪治疗期间报告噩梦减少：一例病例报告。

Reduction in reported nightmares during adjunctive trihexyphenidyl treatment in an adolescent: A case report.

临床研究耳科IF 4.5Q1

文献信息

PMID	42956564
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Noriko Sumitomo 查看其他 11 位作者 Kentaro Matsui；Ayumi Tsuru；Shun Matsushima；Eriya Takahashi；Muneto Izuhara；Megumi Hazumi；Kentaro Nagao；Tomohiro Utsumi；Takuya Yoshiike；Hirofumi Komaki；Kenichi Kuriyama
作者单位	Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan; Department of Sleep Medicine, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan. 查看其他 7 条单位信息 Department of Sleep Medicine, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan; Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan. Electronic address: matsui.kentaro@ncnp.go.jp.；Department of Sleep Medicine, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan.；Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan.；Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan.；Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan; Department of Medical Psychology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan.；Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan; Translational Medical Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan.；Department of Sleep Medicine, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan; Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-higashi, Kodaira, Tokyo, 187-8551, Japan.
期刊	Sleep medicine
SCI 分区	Q1
IF	4.5
研究类型	临床研究 · 临床
所属专科	耳科

中文摘要

背景： 噩梦是创伤后应激障碍（PTSD）常见且致残的症状，并可能持续导致对睡眠的恐惧、失眠和精神状况恶化。儿童和青少年药物治疗的证据仍然有限。我们报告一名13岁患有PTSD的男孩，在辅助三己芬迪（THP）治疗期间报告持续性噩梦停止。方法：多导睡眠图显示呼吸暂停低通气指数为9.4次/小时，快速眼动（REM）睡眠期间为24.5次/小时。患者及其家属倾向于优先处理噩梦和精神科护理，而非治疗阻塞性睡眠呼吸暂停（OSA）。THP以每晚1 mg开始，一周后增至2 mg。结果：在一个月随访时，他报告从治疗第一晚起就没有噩梦，并且尽管未接受OSA治疗，睡眠回避也已缓解。突然停用THP后几天内噩梦复发。结论：尽管这一病程提示THP的作用，但我们无法确定噩梦是停止还是继续但醒后未被回忆。需要进一步研究以明确其疗效、安全性、剂量和患者选择。

英文摘要

Nightmares are a frequent and disabling symptom of posttraumatic stress disorder (PTSD) and may perpetuate fear of sleep, insomnia, and psychiatric deterioration. Evidence for pharmacologic treatment in children and adolescents remains limited. We report a 13-year-old boy with PTSD who reported cessation of persistent nightmares during adjunctive trihexyphenidyl (THP) treatment. Polysomnography showed an apnea-hypopnea index of 9.4/h, with 24.5/h during rapid eye movement (REM) sleep. The patient and his family preferred to prioritize nightmare management and psychiatric care over treatment of obstructive sleep apnea (OSA). THP was started at 1 mg nightly and increased to 2 mg after one week. At one-month follow-up, he reported no nightmares from the first treatment night, and sleep avoidance had resolved despite receiving no OSA treatment. Nightmares recurred within days of abrupt THP discontinuation. Although this course suggests a contribution of THP, we cannot determine whether nightmares ceased or continued without being recalled after awakening. Further studies are needed to clarify its efficacy, safety, dosing, and patient selection.