Understanding Recent Insights in Sleep and Posttraumatic Stress Disorder from a Research Domain Criteria (RDoC) Framework

Abstract

Posttraumatic stress disorder (PTSD) is associated with sleep disturbances, including insomnia, nightmares, sleep-disordered breathing, and REM abnormalities. Recent studies have expanded our knowledge of the neurobiology of trauma and sleep. In addition, intervention research has provided valuable information about how sleep treatments affect PTSD symptoms and how PTSD treatments affect sleep symptoms. This review of recent literature aims to move away from the categorical approach that currently dominates our conceptualization of trauma response and sleep disorders. Possible mechanisms of both trauma and sleep disturbance are posed within the framework put forth by the National Institute of Mental Health's (NIMH) Research Domain Criteria (RDoC) project. By examining domains of dysfunction that cut across disorders, RDoC may guide future research and treatment of the maladaptive neurobiological and behavioral correlates of both trauma and sleep disturbances.

Sleep apnea and posttraumatic stress after traumatic brain injury (TBI): A Veterans Affairs TBI Model Systems study.

“…The medial prefrontal cortex performs a “top down” control function of the amygdala that plays a key role in emotional processes. PTSD samples demonstrate a deficiency of the ability of the medial prefrontal context to regulate the hyperactivity of the amygdala (Kelly et al, 2016). Thus, sleep apnea may further weaken the connection between the parts of the brain that regulate emotions and the emotion areas (Kelly et al, 2016).…”

“…Sleep apnea decreases sleep duration and quality that are needed to process traumatic memories (Gilbert et al, 2015), extinguish fear responses (Djonlagic et al, 2020; Reist et al, 2021), and recover from PTSD. Additionally, sleep apnea’s hypoxemia affects the fiber integrity of white matter tracts that connect the prefrontal cortex to the limbic structures, making it more difficult to regulate emotions (Kelly et al, 2016). CPAP use is associated with reductions in PTSD symptoms even without PTSD focused treatment (El-Solh et al, 2017; Tamanna et al, 2014; Zhang et al, 2019).…”

Understanding Psychological Symptoms of Endometriosis from a Research Domain Criteria Perspective

“…The aim of this narrative review is to not only demonstrate the burden that patients with endometriosis carry, but to also detect transdiagnostic interrelations in the pathogenesis and perpetuation of psychological symptoms to further identify possible prevention and treatment approaches addressing these mechanisms. Therefore, the review of current evidence was structured by the two RDoC domains of Negative Valence Systems and Systems for Social Processes, since these seem to capture the psychopathology of endometriosis most accurately; the Negative Valence Systems are linked to symptoms of depression [ 20 ], anxiety [ 21 ], and post-traumatic stress [ 22 ], while Systems for Social Processes cover the social factors relevant to endometriosis such as social withdrawal, perceived injustice, and social support [ 23 ]. Both will shortly be illustrated at the beginning of each respective section.…”