Trauma-induced insomnia: A novel model for trauma and sleep research

Sinha, Smit S.

doi:10.1016/j.smrv.2015.01.008

Cited by 118 publications

(95 citation statements)

References 117 publications

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“…Converging lines of research on trauma, stress and sleep neurobiology and psychophysiology provide insight on possible mechanisms that underlie associations between childhood adversities and risk of insomnia in adolescence 52 . Substantial evidence shows that exposure to trauma evokes an intense stress/fear response that initiates hyperarousal in specific brain areas (e.g., amygdala, prefrontal cortex, reticular activating system) 52,53 .…”

Section: Discussionmentioning

confidence: 99%

“…Substantial evidence shows that exposure to trauma evokes an intense stress/fear response that initiates hyperarousal in specific brain areas (e.g., amygdala, prefrontal cortex, reticular activating system) 52,53 . In turn, this hyperarousal leads to exaggerated reactivity of the hypothalamic-pituitary adrenal axis and the sympathetic nervous system, which manifests in a generalized state of physiological and neurobiological hyperarousal that impedes sleep onset and continuity, and may ultimately contribute to chronic insomnia 52,54,55 .…”

Section: Discussionmentioning

confidence: 99%

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Childhood adversity and insomnia in adolescence

et al. 2016

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Objective To evaluate the association between exposure to childhood adversity and insomnia, with an emphasis on the role of adversity type, timing, and accumulation (i.e. the number of specific types of adversities the child reported being exposed to). Methods Our analytic sample comprised 9,582 adolescents from the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a nationally-representative population-based sample. We examined the association between 18 different types of retrospectively-reported adversities (capturing interpersonal violence, accidents and injuries, social network or witnessing events, other adverse events) and risk of self-reported past-year insomnia. We also examined whether the age at first exposure to adversity was associated with risk for insomnia, and whether exposure to a greater number of different types of adversities (i.e. accumulation) conferred an elevated risk for insomnia. Additionally, we performed a sensitivity analysis excluding adolescents with a past-year diagnosis of major depression, dysthymia, post-traumatic stress disorder, or generalized anxiety disorder. Results Almost one third of adolescents reported insomnia, with a higher prevalence among girls and those from racial/ethnic minority groups. Adolescents exposed to at least one childhood adversity of any type (59.41%) were more likely than their non-exposed peers to experience insomnia (across adversities, prevalence ratios ranged from 1.31 to 1.89). Risk of insomnia differed based on the age at first exposure to adversity as well as the type of adversity. Adolescents exposed to a greater number of different types of adversities had a higher risk of insomnia compared to those experiencing fewer adversities. These results were similar, by and large, to those obtained after excluding adolescents with at least one of the four past-year psychiatric disorders. Conclusions Exposure to adversity confers an elevated risk for insomnia. This association varied by type, timing, and accumulation of exposure and did not appear to be driven by psychiatric disorders. Given the well-documented physical and mental health consequences of insomnia, such findings add further support to the need for practitioners to screen children for exposure to childhood adversity and insomnia symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Childhood adversity and insomnia in adolescence

et al. 2016

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“…We hypothesized that use of the intervention would be associated with decreased levels of symptomatology, decreased temporal lobe high frequency electrical asymmetry, and improvements in parasympathetic measures of autonomic cardiovascular regulation. Temporal lobe asymmetry was chosen because of predictions associated with the BHAM, and a high frequency range of electrical activity was chosen in consideration of potential associations between trauma, sleep disturbance, and increased activity in this range [27, 28]. Secondarily we explored for possible relationships between baseline temporal lobe high frequency asymmetry, symptom severity, and heart rate variability.…”

Section: Introductionmentioning

confidence: 99%

Clinical, hemispheric, and autonomic changes associated with use of closed-loop, allostatic neurotechnology by a case series of individuals with self-reported symptoms of post-traumatic stress

et al. 2017

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BackgroundThe objective of this pilot study was to explore the use of a closed-loop, allostatic, acoustic stimulation neurotechnology for individuals with self-reported symptoms of post-traumatic stress, as a potential means to impact symptomatology, temporal lobe high frequency asymmetry, heart rate variability (HRV), and baroreflex sensitivity (BRS).MethodsFrom a cohort of individuals participating in a naturalistic study to evaluate use of allostatic neurotechnology for diverse clinical conditions, a subset was identified who reported high scores on the Posttraumatic Stress Disorder Checklist (PCL). The intervention entailed a series of sessions wherein brain electrical activity was monitored noninvasively at high spectral resolutions, with software algorithms translating selected brain frequencies into acoustic stimuli (audible tones) that were delivered back to the user in real time, to support auto-calibration of neural oscillations. Participants completed symptom inventories before and after the intervention, and a subset underwent short-term blood pressure recordings for HRV and BRS. Changes in temporal lobe high frequency asymmetry were analyzed from baseline assessment through the first four sessions, and for the last four sessions.ResultsNineteen individuals (mean age 47, 11 women) were enrolled, and the majority also reported symptom scores that exceeded inventory thresholds for depression. They undertook a median of 16 sessions over 16.5 days, and 18 completed the number of sessions recommended. After the intervention, 89% of the completers reported clinically significant decreases in post-traumatic stress symptoms, indicated by a change of at least 10 points on the PCL. At a group level, individuals with either rightward (n = 7) or leftward (n = 7) dominant baseline asymmetry in temporal lobe high frequency (23–36 Hz) activity demonstrated statistically significant reductions in their asymmetry scores over the course of their first four sessions. For 12 individuals who underwent short-term blood pressure recordings, there were statistically significant increases in HRV in the time domain and BRS (Sequence Up). There were no adverse events.ConclusionClosed-loop, allostatic neurotechnology for auto-calibration of neural oscillations appears promising as an innovative therapeutic strategy for individuals with symptoms of post-traumatic stress.Trials registrationClinicalTrials.gov #NCT02709369, retrospectively registered on March 4, 2016.

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“…During this conflict, over 4500 rockets were launched at Israel and 70% of the Israeli population was in the rocket range. People may develop acute insomnia after a variety of traumatic events (Sinha, ), for example the 9/11 attacks (Galea et al, ), and exposure to missile attacks (Askenasy & Lewin, ). Thus, our first prediction is that individuals with clinical ASD symptom levels resulting from this conflict would report more disturbed sleep than individuals with sub‐clinical ASD symptoms.…”

Section: Introductionmentioning

confidence: 99%

Trauma‐Related Context Increases Sleep Disturbances in People with Acute Stress Disorder Symptoms

Grossman

Shrira

2016

Stress and Health

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In this study, we addressed how sleep is related to acute stress disorder (ASD) symptoms, and how the presence of a trauma related-context moderates this relationship. This study (N = 140) was carried out during the 2014 Israel-Gaza conflict, during which 70% of Israelis were exposed to missile attacks. Findings show that participants with clinical ASD symptom levels reported more sleep disturbances than participants without clinical ASD symptom levels. More critically, this effect was only evident among respondents who had a reinforced security room in their houses. While reinforced security rooms offer protection against indirect missile damage, their relevance is salient in negative traumatic situations, which individuals with a clinical level of ASD are more sensitive to. Conversely, in houses without a reinforced security room, there was no difference in subjective sleep reports between individuals with or without clinical levels of ASD symptoms. Results are discussed in reference to trauma being activated by context and the ensuing effects on sleep. Theoretical and clinical implications are discussed. Copyright © 2016 John Wiley & Sons, Ltd.

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Trauma-induced insomnia: A novel model for trauma and sleep research

Cited by 118 publications

References 117 publications

Childhood adversity and insomnia in adolescence

Childhood adversity and insomnia in adolescence

Clinical, hemispheric, and autonomic changes associated with use of closed-loop, allostatic neurotechnology by a case series of individuals with self-reported symptoms of post-traumatic stress

Trauma‐Related Context Increases Sleep Disturbances in People with Acute Stress Disorder Symptoms

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