Management of Post-Traumatic Nightmares: a Review of Pharmacologic and Nonpharmacologic Treatments Since 2013

Waltman, Scott H.; Shearer, David S.; Moore, Bret A.

doi:10.1007/s11920-018-0971-2

Cited by 35 publications

(30 citation statements)

References 88 publications

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“…If there is a true difference in sleep in those with PTSD, there is a need to determine whether this is primarily due to recurrent nightmares. If so, sleep therapies that target nightmare disorders might be the most effective option (Zak et al, 2010 ), with Imagery Rescripting Therapy (IRT) currently being the preferred psychological treatment option (Germain, McKeon, & Campbell, 2017 ; Waltman, Shearer, & Moore, 2018 ). Sleep disturbance has also been found to remain residual to therapy for PTSD (Australian Centre for Posttraumatic Mental Health, 2007 ; International Society of Traumatic Stress Studies [ISTSS], 2018 ; Pruiksma et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Sleep disturbance in post-traumatic stress disorder (PTSD): a systematic review and meta-analysis of actigraphy studies

Lewis

Kitchiner

et al. 2020

European Journal of Psychotraumatology

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Background: Sleep disturbance has been described as a 'hallmark' symptom of posttraumatic stress disorder (PTSD). Although there are robust findings of self-reported sleep disturbance in PTSD, evidence of sleep disturbance measured using actigraphy is less certain. Objective: To conduct a systematic review and meta-analysis to determine whether there are any significant differences between individuals with and without PTSD in actigraphderived sleep measures. Method: Case-control studies comparing participants with current PTSD to those without PTSD were eligible for inclusion. Sleep parameters of interest were: (1) total sleep time; (2) sleep onset latency; (3) wake after sleep onset (WASO); and (4) sleep efficiency. Data were meta-analysed as standardised mean differences (SMDs) and potential sources of heterogeneity were explored through meta-regression. Six actigraphy studies with 405 participants were included. Results: There was no evidence of a statistically significant difference between those with and without PTSD in total sleep time (SMD 0.09, 95%CI −0.23 to 0.42); WASO (SMD 0.18, 95% CI −0.06 to 0.43); sleep latency (SMD 0.32, 95%CI −0.04 to 0.69); or sleep efficiency (SMD −0.28, 95%CI −0.78 to 0.21). Conclusions: Further high-quality research is required to determine whether there is a true difference in sleep between those with and without PTSD. Perturbación del sueño en el Trastorno de Estrés Postraumático (TEPT): una revisión sistemática y metaanálisis de estudios de actigrafía Antecedentes: La perturbación del sueño se ha descrito como un síntoma 'distintivo' del trastorno de estrés postraumático (TEPT). Aunque existen hallazgos sólidos de trastornos del sueño en el TEPT a través de auto-reportes, la evidencia de éstos medidos con el uso de actigrafía es más incierta. Objetivo: Realizar una revisión sistemática y un metanálisis para determinar si hay diferencias significativas entre los individuos con y sin TEPT en medidas de sueño derivadas de la actigrafía. Método: Los estudios de casos y controles incluidos como elegibles fueron aquéllos que compararon participantes con TEPT en curso con aquellos participantes sin TEPT. Los parámetros de sueño de interés fueron: (1) tiempo total del sueño; (2) latencia del inicio del sueño; (3) vigilia después del inicio de sueño (wake after sleep onset, WASO, en su sigla en inglés); y (4) eficiencia del sueño. Los datos fueron meta-analizados como diferencias de medias estandarizadas (DME) y se exploraron las posibles fuentes de heterogeneidad mediante metarregresión. Se incluyeron seis estudios de actigrafía con 405 participantes. Resultados: No hubo evidencia de una diferencia estadísticamente significativa entre aquellos con y sin TEPT en el tiempo total del sueño (DME 0.09, IC 95%: −0,23 a 0,42); WASO (DME 0.18, IC 95% −0.06 a 0.43); latencia del sueño (SMD 0.32, IC 95% −0.04 a 0.69); o eficiencia del sueño (SMD −0.28, IC 95% −0.78 a 0.21). Conclusiones: Se requieren futuras investigaciones de alta calidad para determinar si existe una verdadera diferencia ...

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Section: Discussionmentioning

confidence: 99%

Sleep disturbance in post-traumatic stress disorder (PTSD): a systematic review and meta-analysis of actigraphy studies

Lewis

Kitchiner

et al. 2020

European Journal of Psychotraumatology

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“…Such an approach, known as psychological first aid, has given satisfactory results 34) . Pharmacological treatments include antidepressants (such as selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, and monoamine oxidase inhibitors), sympatholytic drugs such as alphablockers, antipsychotics, anticonvulsants, and benzodiazepines 1,35) . In this context, the correct diagnostic assessment of work-related PTSD by hospital occupational medicine units can be very useful to address patients towards an appropriate therapeutic path, in order to promote their psychological well-being and work reintegration.…”

Section: Discussionmentioning

confidence: 99%

Work-related post-traumatic stress disorder: report of five cases

et al. 2020

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Post-traumatic stress disorder (PTSD) may arise after events involving a risk to physical integrity or to life, one’s own or that of others. It is characterized by intrusive symptoms, avoidance behaviors, and hyper-excitability. Outside certain categories (e.g., military and police), the syndrome is rarely described in the occupational setting. We report here five unusual cases of work-related PTSD, diagnosed with an interdisciplinary protocol (occupational health visit, psychiatric interview, psychological counselling and testing): (1) a 51-yr-old woman who had undergone three armed robbery attempts while working in a peripheral post office; (2) a 53-yr-old maintenance workman who had suffered serious burns on the job; (3) a 33-yr-old beauty center receptionist after sexual harassment and stalking by her male employer; (4) a 57-yr-old male psychiatrist assaulted by a psychotic outpatient; (5) a 40-yr-old woman, sales manager in a shoe store, after physical aggression by a thief. All patients required psychiatric help and pharmacological treatment, with difficulty of varying degrees in resuming work. We conclude that PTSD can develop even in professional categories generally considered to be at low risk. In such cases, a correct interdisciplinary diagnostic approach is fundamental for addressing therapy and for medico-legal actions.

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“…Prazosin is an alpha blocker recommended for the treatment of chronic nightmares in PTSD patients ( 107 – 109 ), and in this case, inhibition of the sympathetic nervous system may desensitize memories of fear which could explain the reduction of nightmare frequency induced by this treatment. To our knowledge, the impact of Prazosin on DRF is unknown.…”

Section: Pathologies and Medicationsmentioning

confidence: 99%

Methodological Recommendations to Control for Factors Influencing Dream and Nightmare Recall in Clinical and Experimental Studies of Dreaming

et al. 2020

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In order to ensure robust relationships between the dependent and independent variables in clinical dream/nightmare studies, the major factors which influence the frequency of reported dreams must be controlled. This article sets out methodological recommendations to both researchers seeking to ensure the equivalence of experimental groups of participants in group-matching designs, and to clinicians who wish to check that any change in frequency of reported nightmares over the course of a psychological or a pharmacological intervention is not caused by factors other than the experimental treatment itself. The main factors influencing the frequency of dream recall are presented: demographic variables, psychological characteristics, pathological dimensions, and substance consumption. A series of questionnaires is proposed for easily measuring these control variables.

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Management of Post-Traumatic Nightmares: a Review of Pharmacologic and Nonpharmacologic Treatments Since 2013

Abstract: Preliminary report on childhood sexual abuse, suicidal ideation, and suicide attempts among middle-aged and older depressed women.

Cited by 35 publications

References 88 publications

Sleep disturbance in post-traumatic stress disorder (PTSD): a systematic review and meta-analysis of actigraphy studies

Sleep disturbance in post-traumatic stress disorder (PTSD): a systematic review and meta-analysis of actigraphy studies

Work-related post-traumatic stress disorder: report of five cases

Methodological Recommendations to Control for Factors Influencing Dream and Nightmare Recall in Clinical and Experimental Studies of Dreaming

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