Greater sleep disturbance and longer sleep onset latency facilitate SCR-specific fear reinstatement in PTSD

Zuj, Daniel V.; Palmer, Matthew A.; Malhi, Gin S; Bryant, Richard A.; Felmingham, Kim L.

doi:10.1016/j.brat.2018.08.005

Cited by 14 publications

(16 citation statements)

References 55 publications

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Section: Discussionsupporting

confidence: 92%

“…There was a close relationship among subjective fear, sleep quality, and PTSS, which was in line with the results of previous studies ( 39 – 42 ). For instance, Zuj et al have found that greater sleep disturbance and longer sleep onset latency facilitated SCR-specific fear reinstatement in PTSS ( 39 ). In addition, Fan et al found that sleep disturbance predicted the development and persistence of PTSS and depressive symptoms ( 40 ), suggesting that sleep quality played an important role in both the treatment and prevention of PTSD.…”

Section: Discussionsupporting

confidence: 92%

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Is Higher Subjective Fear Predictive of Post-Traumatic Stress Symptoms in a Sample of the Chinese General Public?

Guo

Liu²,

Xing

et al. 2021

Front. Psychiatry

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Background: COVID-19 has taken a huge toll on medical resources and the economy and will inevitably have an impact on public mental health. Post-traumatic stress disorder (PTSD), as the most common mental illness after an epidemic, must be seriously addressed. This study aimed to investigate the subjective fear of the Chinese general public during COVID-19 and to explore how it affected the development of PTSD.Methods: An online questionnaire survey was conducted among 1,009 people from January 30 to February 14, 2020 (about 1 month after the COVID-19 outbreak). The subjective fear was measured by a self-reported single-choice question. Four items from the Pittsburgh Sleep Quality Index (PSQI) were selected to measure the subjects' sleep quality. Their post-traumatic stress symptoms (PTSS) were measured by the PTSD Checklist for DSM-5 (PCL-5). Pearson correlation, hierarchical multivariate regression analysis, multiple mediator model, and bootstrapping were used in statistical analyses.Results: Different people showed different levels of subjective fear in response to the outbreak. There was a significant positive correlation between subjective fear and the total score of PCL-5 (R = 0.513, P < 0.01), meaning that the higher the degree of subjective fear, the more severe the symptoms of post-traumatic stress are. Subjective fear was an important predictor of PTSS, accounting for 24.3% of the variance. The total effect of subjective fear on PCL-5 scores was significant (total effect = 7.426, SE = 0.405, 95% CI = 6.631–8.221). The total indirect effect of subjective fear on PCL-5 scores through sleep quality was also significant (total indirect effect = 1.945, SE = 0.258, 95% CI = 1.436–2.470).Conclusions: Subjective fear has an important predictive effect on PTSS. In addition to the direct effect, our findings firstly demonstrate the mediating role of sleep quality in the relationship between subjective fear and PTSS.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Is Higher Subjective Fear Predictive of Post-Traumatic Stress Symptoms in a Sample of the Chinese General Public?

Guo

Liu²,

Xing

et al. 2021

Front. Psychiatry

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“…Results also supported our hypothesis that poor sleep quality would be most closely associated with worsening of PTSD in those who were experiencing greater anticipatory threat. This finding is in line with evidence that fear reinstatement is associated with more severe PTSD symptoms but only among individuals with poor sleep (Zuj et al, 2018 ). Additionally, poor baseline sleep quality has been shown to interfere with trauma‐focussed treatment among Veterans with PTSD and traumatic brain injury (Sullan et al, 2021 ).…”

Section: Discussionsupporting

confidence: 91%

Worse sleep, worsening post‐traumatic stress disorder (PTSD): Poor sleep quality associated with increases in PTSD symptoms amongst those experiencing high threat of the COVID‐19 pandemic

Straus

Dolsen

Nishimi

et al. 2022

Journal of Sleep Research

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Summary The coronavirus disease 2019 (COVID‐19) pandemic is a global health crisis with the potential to elicit and worsen psychiatric symptoms, particularly post‐traumatic stress disorder (PTSD) symptoms. Identifying modifiable protective factors is critical for preventing and treating PTSD symptoms both during and following the COVID‐19 pandemic. The present study examined associations of self‐reported sleep quality and anticipatory threat appraisals of the pandemic with PTSD symptoms 6 months later in a sample enriched for pre‐pandemic trauma exposure and PTSD. The sample included 590 adults (mean age 38.2 years) who completed a baseline survey in August/September 2020 and follow‐up survey in March/April 2021. The sample was recruited from a pool of participants interested in a prior study about traumatic stress. Participants self‐reported sleep quality and pandemic‐related anticipatory threat appraisals at baseline. PTSD symptoms were assessed at baseline and follow‐up. Baseline sleep quality was associated with PTSD symptoms at follow‐up controlling for baseline PTSD symptoms ( B = −2.49, p = 0.001). Perceived anticipatory threat of the pandemic moderated this association such that worse sleep quality was related to more severe PTSD symptoms at follow‐up for participants with higher ( B = −4.07, p < 0.001) but not lower ( B = −0.43, p = 0.679) anticipatory threat about the COVID‐19 pandemic. These findings suggest that poor sleep quality may enhance vulnerability to later PTSD symptoms during the pandemic, particularly among those individuals who perceived the pandemic as threatening for their future. Treatments that address sleep problems may be beneficial for reducing trauma‐related symptoms during and following the global health crisis.

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“…Studies in humans reported a delayed sleep onset in generalized anxiety disorder 64 and panic disorder 20,65 . In PTSD patients, one study associated longer sleep onset latency with more severe fear reinstatement and PTSD symptomatology 66 . The occurrence of insomnia was even proposed as a predictor of anxiety and other mental disorders 24 .…”

Section: Insomnia-like Features: Increased Sleep Latency and Awakenings From Rems In The Light Periodmentioning

confidence: 99%

Altered sleep behavior in a genetic mouse model of impaired fear extinction

Fritz

Kreuzer

Altunkaya

et al. 2021

Sci Rep

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Sleep disturbances are a common complaint of anxiety patients and constitute a hallmark feature of post-traumatic stress disorder (PTSD). Emerging evidence suggests that poor sleep is not only a secondary symptom of anxiety- and trauma-related disorders but represents a risk factor in their development, for example by interfering with emotional memory processing. Fear extinction is a critical mechanism for the attenuation of fearful and traumatic memories and multiple studies suggest that healthy sleep is crucial for the formation of extinction memories. However, fear extinction is often impaired in anxiety- and trauma-related disorders—an endophenotype that is perfectly modelled in the 129S1/SvImJ inbred mouse strain. To investigate whether these mice exhibit altered sleep at baseline that could predispose them towards maladaptive fear processing, we compared their circadian sleep/wake patterns to those of typically extinction-competent C57BL/6 mice. We found significant differences regarding diurnal distribution of sleep and wakefulness, but also sleep architecture, spectral features and sleep spindle events. With regard to sleep disturbances reported by anxiety- and PTSD patients, our findings strengthen the 129S1/SvImJ mouse models’ face validity and highlight it as a platform to investigate novel, sleep-focused diagnostic and therapeutic strategies. Whether the identified alterations causally contribute to its pathological anxiety/PTSD-like phenotype will, however, have to be addressed in future studies.

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Greater sleep disturbance and longer sleep onset latency facilitate SCR-specific fear reinstatement in PTSD

Cited by 14 publications

References 55 publications

Is Higher Subjective Fear Predictive of Post-Traumatic Stress Symptoms in a Sample of the Chinese General Public?

Is Higher Subjective Fear Predictive of Post-Traumatic Stress Symptoms in a Sample of the Chinese General Public?

Worse sleep, worsening post‐traumatic stress disorder (PTSD): Poor sleep quality associated with increases in PTSD symptoms amongst those experiencing high threat of the COVID‐19 pandemic

Altered sleep behavior in a genetic mouse model of impaired fear extinction

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