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Sleep Disturbances in the Aftermath of Trauma and Posttraumatic Stress Disorder

Published online by Cambridge University Press:  07 November 2014

Thomas A. Mellman  and
Maria Mananita S. Hipolito
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Abstract

Sleep disturbances, including nightmares and insomnia, are prominent following trauma and with posttraumatic stress disorder (PTSD) and likely contribute to the pathogenesis of the disorder. Findings from laboratory studies of PTSD have been inconsistent in terms of documenting objective impaired sleep maintenance but have been somewhat more consistent in indicating alterations of rapid eye movement (REM) sleep. Studies of the early aftermath of trauma can reduce the complexity associated with chronicity and comorbidity, and may have implications for early diagnosis and prevention. Multiple studies indicate that dream content is affected by recent threatening experiences. The development of PTSD is associated with a more replicative type of nightmare content. Sleep is reported to be generally disrupted following trauma especially among those developing PTSD. The limited number of studies that provide objective recorded indices during the early aftermath of trauma also provide a mixed picture regarding overall sleep maintenance. Recent data suggest that a more specific disruption of REM sleep may be associated with the development of PTSD and that this disruption is associated with an increased signal of sympathetic nervous system activation during REM sleep. Disrupted REM sleep and increased sympathetic/noradrenergic activity may have implications for understanding recent promising interventions for PTSD sleep disturbance that can be applied to early intervention.

Type
Review Articles
Information
CNS Spectrums , Volume 11 , Issue 8 , August 2006 , pp. 611 - 615
Copyright
Copyright © Cambridge University Press 2006

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References

REFERENCES

1.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. text rev. Washington, D.C.: American Psychiatric Association; 2000.Google Scholar
2.Neylan, TC, Marmar, CR, Metzler, TJ, et al.Sleep disturbances in the Vietnam generation: findings from a nationally representative sample of male Vietnam veterans. Am J Psychiatry. 1998;155:929–933.Google Scholar
3.Green, BL. Disasters and posttraumatic stress disorder. In: Davidson, JRT, Foa, EB, eds. Posttraumatic Stress Disorder DSM-IV and Beyond. Washington, D.C.: American Psychiatric Press; 1993:75–97.Google Scholar
4.Mellman, TA, David, D, Kulick-Bell, R, Hebding, J, Nolan, B. Sleep Disturbance and its Relationship to Psychiatric Morbidity Following Hurricane Andrew. Am J Psychiatry. 1995;152:1659–1663.Google ScholarPubMed
5.Koren, D, Arnon, I, Lavie, P, Klein, E. Sleep complaints as early predictors of post-traumatic stress disorder: a 1-year prospective study of injured survivors of motor vehicle accidents. Am J Psychiatry. 2002;159:855–857.Google Scholar
6.Mellman, TA, David, D, Bustamante, V, Torres, J, Fins, A. Dreams in the Acute aftermath of trauma and their relationship to PTSD. J Trauma Stress. 2001;14:241–247.Google Scholar
7.Bonnet, MH. Acute sleep deprivation. In: Kryger, MH, Roth, T, Dement, WC, eds. Principles and Practice of Sleep Medicine. 4th ed. Philadelphia, Penn: Elsevier Saunders; 2005:51–66.Google Scholar
8.Mellman, TA. Sleep and the pathogenesis of PTSD. In: Shalev, A, Yehuda, R, McFarlane, AC, eds. International Handbook of Human Response to Trauma. New York, NY: Plenum Publishing Company; 2000:299–306.Google Scholar
9.Lavie, P. Current concepts: sleep disturbances in the wake of traumatic events. N Engl J Med. 2001;345:1825–1832.CrossRefGoogle Scholar
10.Ross, RJ, Ball, WA, Dinges, DF, et al.Rapid eye movement sleep disturbance in post-traumatic stress disorder. Biol Psychiatry. 1994;35:195–202.Google Scholar
11.Ross, RJ, Ball, WA, Dinges, DF, et al.Motor dysfunction during sleep in posttraumatic stress disorder. Sleep. 1994;17:723–732.CrossRefGoogle ScholarPubMed
12.Mellman, TA, Nolan, B, Hebding, J, Kulick-Bell, R, Dominguez, R. A polysomnographic comparison of veterans with combat-related PTSD, depressed men, and non-ill controls. Sleep. 1996;20:46–51.Google Scholar
13.Mellman, TA, Kulick-Bell, R, Ashlock, LE, Nolan, B. Sleep events among veterans with combat-related posttraumatic stress disorder. Am J Psychiatry. 1995;152:110–115.Google Scholar
14.Breslau, N, Roth, T, Burduvali, E, Kapke, A, Schultz, L, Roehrs, T. Sleep in lifetime post-traumatic stress disorder: a community-based polysomnographic study. Arch Gen Psychiatry. 2004;61:508–516.Google Scholar
15.Ford, DE, Kamerow, DB. Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA. 1989;262:1479–1484.Google Scholar
16.Wood, JM, Bootzin, RR, Rosenhan, D, Nolen-Hoeksema, S, Jourden, F. Effects of the 1989 San Francisco earthquake on frequency and content of nightmares. J Abnorm Psychol. 1992;101:219–224.CrossRefGoogle ScholarPubMed
17.Pagel, JF, Vann, BH, Altomare, CA. Reported association of stress and dreaming: community background levels and changes with disaster (Hurricane Iniki). Dreaming. 1995;5:43–50.Google Scholar
18.Siegel, A. Dreams of firestorm survivors. In: Barrett, D, ed. Trauma and Dreams. Harvard University Press; 1996:162–165.Google Scholar
19.Terr, LC. Children of Chowcilla: a study of psychic trauma. Psychoanal Study Child. 1979;34:547–563.CrossRefGoogle ScholarPubMed
20.Pynoos, RS, Nader, K. Children who witness the sexual assaults of their mothers. J Am Acad Child Adolesc Psychiatry. 1988;27:567–572.Google Scholar
21.David, D, Mellman, TA. Dreams following Hurricane Andrew. Dreaming. 1997;7:209–214.Google Scholar
22.Schlosberg, A, Benjamin, M. Sleep patterns in three acute combat fatigue cases. J Clin Psychiatry. 1978;39:546–549.Google ScholarPubMed
23.Klein, E, Koren, D, Arnon, I, Lavie, P. Sleep complaints are not corroborated by objective sleep measures in post-traumatic stress disorder: a 1-year prospective study in survivors of motor vehicle crashes. J Sleep Res. 2003;2:35–41.Google Scholar
24.Klein, E, Koren, D, Arnon, I, Lavie, P. No evidence of sleep disturbance in post-traumatic stress disorder: a polysomnographic study in injured victims of traffic accidents. Isr J Psychiatry Relat Sci. 2002;39:3–10.Google Scholar
25.Mellman, TA, Bustamante, V, Fins, AI, Pigeon, WR, Nolan, B. REM sleep and the early development of posttraumatic stress disorder. Am J Psychiatry. 2002;159:1696–1701.Google Scholar
26.Weathers, FW, Keane, TM, Davidson, JR. Clinician-administered PTSD scale: a review of the first ten years of research. Depress Anxiety. 2001;13:132–156.CrossRefGoogle Scholar
27.Southwick, SM, Bremner, JD, Rasmusson, A, Morgan, CA, Arnsten, A, Charney, DS. Role of norepinephrine in the pathophysiology and treatment of posttraumatic stress disorder. Biol Psychiatry 1999;46:1192–1204.Google Scholar
28.Mellman, TA, Kumar, A, Kulick-Bell, R, Kumar, M, Nolan, B. Noradrenergic and sleep measures in combat-related PTSD. Biol Psychiatry. 1995;38:174–179.Google Scholar
29.Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996;93:1043–1065.Google Scholar
30.Mellman, TA, Knorr, BR, Pigeon, WR, Leiter, JC, Akay, M. Heart rate variability during sleep and the early development of PTSD. Biol Psychiatry. 2004;55:953–956.CrossRefGoogle Scholar
31.Pitman, RK, Sanders, KM, Zusman, RM, et al.Pilot study of secondary prevention of posttraumatic stress disorder with propranolol. Biol Pychiatry. 2002;51:189–192.CrossRefGoogle ScholarPubMed
32.Raskind, MA, Peskind, ER, Kanter, ED, et al.Reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: a placebo-controlled study. Am J Psychiatry. 2003;160:371–373.Google Scholar
33.Robert, R, Blakeney, PE, Villarreal, C, Rosenberg, L, Meyer, WJ 3rd. Imipramine treatment in pediatric burn patients with symptoms of acute stress disorder: a pilot study. J Am Acad Child Adolesc Psychiatry. 1999;38:873–882.Google Scholar
34.Winokur, A, Gary, KA, Rodner, S, Rae-Red, C, Fernando, AT, Szuba, MP. Depression, sleep physiology, and antidepressant drugs. Depress Anxiety. 2001;14:19–28.Google Scholar
35.Krakow, B, Hollifield, M, Johnston, L, et al.Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: a randomized controlled trial. JAMA. 2001;286:537–545.Google Scholar