Post-Traumatic Sleep-Wake Disorders

Abstract

All living organisms that face a traumatic life event are susceptible to sleep-wake disturbances. Stress, which can result in trauma, evokes a high level of physiological arousal associated with sympathetic nervous system activation, during both sleep and wakefulness. Heredity, sex hormones, early losses, developmental factors and intra- and interpersonal conflicts, contribute to the level of baseline physiological arousal, producing either subclinical, clinical or complex clinical traits, acutely and at any time after exposure to a traumatic event. The risk of acute sleep-wake disturbances becoming disorders and syndromes depends on the type of traumatic event and all of the aforementioned factors. Taken together, with consideration for behavioural and environmental heterogeneity, in research, will aid identification and understanding of susceptibility factors in long-term sleep and wakefulness pathology after exposure to traumatic events.

Trajectories of Fatigue, Psychological Distress, and Coping Styles After Mild Traumatic Brain Injury: A 6-Month Prospective Cohort Study

“…Main Outcome Measures Fatigue was measured with the fatigue severity subscale of the Checklist Individual Strength, including 8 items (sum scores 8-56). Subsequently, three clinical categories were created: high (40-56), moderate (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) and low (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25).…”

“…Fatigue: Fatigue was measured with the fatigue severity subscale of the Checklist Individual Strength (CIS) 13 , including 8 items measuring fatigue symptoms over the past two weeks, with scores being classified as high (40-56), moderate (26-39) and low (8-25). 14 Anxiety and depression: Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) 15 , including 14-items measuring both constructs separately, with scores being classified as high (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21), moderate (8)(9)(10) and low (0-7).…”

“…Furthermore, patients may develop anxiety and post-traumatic stress resulting in sleeping difficulties. 9,10 Additionally, coping style, the way one deals with stressful situations, has also been related to fatigue levels. 6 Coping style is generally divided into active coping (an external problem-solving approach) and passive coping (a more internal emotionfocused approach).…”

Exploration of the Relationships Between Stress and Distinct Pain and Sleep Disturbance Profiles in Patients Undergoing Chemotherapy

“…Our evaluation of stress included measures of global, cancer-specific, and cumulative life stress. Of particular importance to this discussion and not well studied on oncology patients is the relationships Romanovska et al between sleep disturbance and pain in the context of stress, particularly PTSD, 66,67 and adverse childhood experiences (ACEs). [68][69][70] As noted in 1 review, 68 at least 1 out of every 10 people seeking medical care has experienced an ACE, and the trauma associated with this experience contributes to an increased risk for common medical conditions.…”

The mediational roles of sleep disorders and nightmares in the relationship between trauma and dissociation.

“…Traumatic events have long been believed to lead to sleep disturbances, daytime symptoms of dissociation (e.g., flashbacks; Marich & Zupanick, n.d.a), and nighttime symptoms of dissociation (e.g., nightmares; American Psychiatric Association, 2000; Gershuny & Thayer, 1999; Harvey, Jones, & Schmidt, 2003; Marich & Zupanick, n.d.b; Mollayeva, D’Souza, Mollayeva, & Colantonio, 2017). Proponents of the “sleep-dissociation” perspective (Lynn, Lilienfeld, Merckelbach, Giesbrecht, & Van der Kloet, 2012; Van der Kloet, Merckelbach, Giesbrecht, & Lynn, 2012) have argued that trauma causes these anomalies because aversive events both disrupt the sleep–wake cycle and increase the vulnerability to dissociative symptoms.…”