Polysomnography in patients with post‐traumatic stress disorder

Abstract

Aims:The purpose of the present study was to investigate sleep structure in post-traumatic stress disorder (PTSD) patients with and without any psychiatric comorbidities. The relationship between sleep variables and measurements of clinical symptom severity were also investigated.Methods: Sleep patterns of 24 non-medicated male PTSD patients and 16 age-and sex-matched normal controls were investigated on polysomnography on two consecutive nights. Six PTSD-only patients and 15 PTSD patients with major depressive disorder (MDD) were also compared to normal controls. Sleep variables were correlated with PTSD symptoms.Results: Compared to the normal controls, the PTSD patients with MDD had difficulty initiating sleep, poor sleep efficiency, decreased total sleep time, decreased slow wave sleep (SWS), and a reduced rapid eye movement (REM) sleep latency. The PTSD patients without any comorbid psychiatric disorders had moderately significant disturbances of sleep continuity, and decreased SWS, but no abnormalities of REM sleep. REM sleep latency was inversely proportional to the severity of startle response. SWS was found to be inversely correlated with the severity of psychogenic amnesia.Conclusions: PTSD patients have disturbance of sleep continuity, and SWS deficit, without the impact of comorbid depression on sleep. The relationship between SWS and the inability to recall an important aspect of trauma may indicate the role of sleep in the consolidation of traumatic memories. The relationship between the severity of the startle response and REM latency may suggest that REM sleep physiology shares common substrates with the symptoms of PTSD.

REM Sleep Depotentiates Amygdala Activity to Previous Emotional Experiences

“…Of special relevance in this context is the condition of PTSD, characterized by REM abnormalities [11, 32–35], hyper-arousal [36–40] and exaggerated amygdala reactivity [41–43]. Indeed, the current findings offer a putative neurobiological explanation for the recent pharmacological treatment success involving nighttime suppression of adrenergic activity in PTSD, restoring REM sleep features and improving clinical symptomatology [12, 44, 45].…”

Improvement of mood and sleep alterations in posttraumatic stress disorder patients by eye movement desensitization and reprocessing

“…Summation of these events may have led to the significantly longer waking time after sleep onset in PTSD patients observed before treatment. Studies concerning the sleep pattern of PTSD patients consensually report problems of sleep continuity (Mellman et al, 1995b; Yetkin et al, 2010; Capaldi et al, 2011) and EMDR was capable of restoring WASO to normal levels, as seen in healthy volunteers. Moreover, this therapy also increased sleep efficiency, resulting in a more consolidated sleep, although before the onset of treatment PTSD patients displayed similar values compared to control subjects.…”

Premigration Persecution, Postmigration Stressors and Resources, and Postmigration Mental Health

“…Research suggests that some aspects of HPA axis regulation in co-morbid PTSD-MDD are distinctly different from what is seen in “pure” MDD and “pure” PTSD (de Kloet, Vermetten, Lentjes, Geuze, van Pelt, Manuel, et al 2008; Vythilingam, Gill, Luckenbaugh, Gold, Collin, Bonne, et al 2010). Moreover, research regarding the sleep structure of individuals with PTSD, and co-morbid PTSD-MDD argue for more and different types of sleep disturbances in the latter group (Yetkin, Aydin, & Özgen, 2010). However, De kloet, et al (2008) conclude that symptom levels in these two groups are not sufficiently different to argue for co-morbid PTSD-MDD being distinctly different from PTSD.…”