scholarly journals REM sleep in acutely traumatized individuals and interventions for the secondary prevention of post-traumatic stress disorder

2020 ◽  
Vol 11 (1) ◽  
pp. 1740492 ◽  
Author(s):  
Dimitris Repantis ◽  
Katharina Wermuth ◽  
Nikolaos Tsamitros ◽  
Heidi Danker-Hopfe ◽  
Jan Christoph Bublitz ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Rem Sleep ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Post Traumatic

scholarly journals The spectral fingerprint of sleep problems in post-traumatic stress disorder

SLEEP ◽  
2019 ◽  
Vol 43 (4) ◽  
Author(s):  
M de Boer ◽  
M J Nijdam ◽  
R A Jongedijk ◽  
K A Bangel ◽  
M Olff ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Rem Sleep ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Sleep Problems ◽  
Nrem Sleep ◽  
Post Traumatic Stress ◽  
Oscillation Power ◽  
Post Traumatic

Abstract Study Objectives Sleep problems are a core feature of post-traumatic stress disorder (PTSD). The aim of this study was to find a robust objective measure for the sleep disturbance in patients having PTSD. Methods The current study assessed EEG power across a wide frequency range and multiple scalp locations, in matched trauma-exposed individuals with and without PTSD, during rapid eye movement (REM) and non-REM (NREM) sleep. In addition, a full polysomnographical evaluation was performed, including sleep staging and assessment of respiratory function, limb movements, and heart rate. The occurrence of sleep disorders was also assessed. Results In patients having PTSD, NREM sleep shows a substantial loss of slow oscillation power and increased higher frequency activity compared with controls. The change is most pronounced over right-frontal sensors and correlates with insomnia. PTSD REM sleep shows a large power shift in the opposite direction, with increased slow oscillation power over occipital areas, which is strongly related to nightmare activity and to a lesser extent with insomnia. These pronounced spectral changes occur in the context of severe subjective sleep problems, increased occurrence of various sleep disorders and modest changes in sleep macrostructure. Conclusions This is the first study to show pronounced changes in EEG spectral topologies during both NREM and REM sleep in PTSD. Importantly, the observed power changes reflect the hallmarks of PTSD sleep problems: insomnia and nightmares and may thus be specific for PTSD. A spectral index derived from these data distinguishes patients from controls with high effect size, bearing promise as a candidate biomarker.

scholarly journals The Spectral Fingerprint of Sleep Problems in Post-Traumatic Stress Disorder

2017 ◽  
Author(s):  
M. de Boer ◽  
M.J. Nijdam ◽  
R.A. Jongedijk ◽  
Olff ◽  
W.F. M. Hofman ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Rem Sleep ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Sleep Problems ◽  
Nrem Sleep ◽  
Post Traumatic Stress ◽  
Oscillation Power ◽  
Post Traumatic

AbstractBACKGROUNDSleep problems are a core feature of post-traumatic stress disorder (PTSD). However, a robust objective measure for the sleep disturbance in patients has yet to be found.METHODSThe current study assessed EEG power across a wide frequency range and multiple scalp locations, in matched trauma-exposed individuals with and without PTSD, during rapid eye movement (REM) and non-REM (NREM) sleep. In addition, a full polysomnographical evaluation was performed, including sleep staging and assessment of respiratory function, limb movements and heart rate. The occurrence of sleep disorders was also assessed.RESULTSIn PTSD patients, NREM sleep shows a substantial loss of slow oscillation power and increased higher frequency activity compared to controls. The change is most pronounced in right-frontal brain areas and correlates with insomnia. PTSD REM sleep shows a large power shift in the opposite direction, with increased slow oscillation power in occipital areas, which is strongly related to nightmare activity and to lesser extent with insomnia. These pronounced spectral changes occur in the context of severe subjective sleep problems, increased occurrence of various sleep disorders and modest changes in sleep macrostructure.CONCLUSIONSThis is the first study to show pronounced changes in EEG spectral topologies during both NREM and REM sleep in PTSD. Importantly, the observed power changes reflect the hallmarks of PTSD sleep problems: insomnia and nightmares and may thus be specific for PTSD. A spectral index derived from these data distinguishes patients from controls with high effect size, bearing promise as a candidate biomarker.

scholarly journals Alterations in sleep electroencephalography synchrony in combat-exposed veterans with post-traumatic stress disorder

SLEEP ◽  
2020 ◽  
Vol 43 (7) ◽  
Author(s):  
Srinivas Laxminarayan ◽  
Chao Wang ◽  
Sridhar Ramakrishnan ◽  
Tatsuya Oyama ◽  
J David Cashmere ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Sleep Stage ◽  
Brain Regions ◽  
Sleep Stages ◽  
Alpha Band ◽  
Post Traumatic Stress ◽  
Post Traumatic

Abstract Study Objectives We assessed whether the synchrony between brain regions, analyzed using electroencephalography (EEG) signals recorded during sleep, is altered in subjects with post-traumatic stress disorder (PTSD) and whether the results are reproducible across consecutive nights and subpopulations of the study. Methods A total of 78 combat-exposed veteran men with (n = 31) and without (n = 47) PTSD completed two consecutive laboratory nights of high-density EEG recordings. We computed a measure of synchrony for each EEG channel-pair across three sleep stages (rapid eye movement [REM] and non-REM stages 2 and 3) and six frequency bands. We examined the median synchrony in 9 region-of-interest (ROI) pairs consisting of 6 bilateral brain regions (left and right frontal, central, and parietal regions) for 10 frequency-band and sleep-stage combinations. To assess reproducibility, we used the first 47 consecutive subjects (18 with PTSD) for initial discovery and the remaining 31 subjects (13 with PTSD) for replication. Results In the discovery analysis, five alpha-band synchrony pairs during non-REM sleep were consistently larger in PTSD subjects compared with controls (effect sizes ranging from 0.52 to 1.44) across consecutive nights: two between the left-frontal and left-parietal ROIs, one between the left-central and left-parietal ROIs, and two across central and parietal bilateral ROIs. These trends were preserved in the replication set. Conclusion PTSD subjects showed increased alpha-band synchrony during non-REM sleep in the left frontoparietal, left centro-parietal, and inter-parietal brain regions. Importantly, these trends were reproducible across consecutive nights and subpopulations. Thus, these alterations in alpha synchrony may be discriminatory of PTSD.

Abnormal REM Sleep Atonia Control in Chronic Post-Traumatic Stress Disorder

SLEEP ◽  
2021 ◽  
Author(s):  
John C Feemster ◽  
Tyler A Steele ◽  
Kyle P Palermo ◽  
Christy L Ralston ◽  
Yumeng Tao ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Sleep Disturbances ◽  
Stress Disorder ◽  
Rem Sleep Behavior Disorder ◽  
Post Traumatic Stress ◽  
Sleep Behavior ◽  
Chronic Ptsd ◽  
Post Traumatic

Abstract Study Objectives Post-traumatic stress disorder (PTSD) and REM sleep behavior disorder (RBD) share some common features including prominent nightmares and sleep disturbances. We aimed to comparatively analyze REM sleep without atonia (RSWA) between patients with chronic PTSD with and without dream enactment behavior (DEB), isolated RBD (iRBD), and controls. Methods In this retrospective study, we comparatively analyzed 18 PTSD with DEB (PTSD+DEB), 18 PTSD without DEB, 15 iRBD, and 51 controls matched for age and sex. We reviewed medical records to determine PTSD clinical features and quantitatively analyzed RSWA. We used non-parametric analyses to compare clinical and polysomnographic features. Results PTSD patients, both with and without DEB, had significantly higher RSWA than controls (all p < 0.025, excepting submentalis phasic duration in PTSD+DEB). Most RSWA measures were also higher in PTSD+DEB than in PTSD without DEB patients (all p <0.025). Conclusions PTSD patients have higher RSWA than controls, whether DEB is present or not, indicating that REM sleep atonia control is abnormal in chronic PTSD. Further prospective studies are needed to determine whether neurodegenerative risk and disease markers similar to RBD might occur in PTSD patients.

scholarly journals New insights into secondary prevention in post-traumatic stress disorder

2011 ◽  
Vol 13 (3) ◽  
pp. 301-309 ◽  
Keyword(s):  
Secondary Prevention ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Recovery Process ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Small Pilot Study ◽  
Post Traumatic

Post-traumatic stress disorder (PTSD) is unique amongst psychiatric disorders in two ways. Firstly, there is usually a very clear point of onset- the traumatic event The second unique feature of PTSD is that it is characterized by a failure of the normal response to resolve. Given these two characteristics, PTSD appears a good candidate for secondary prevention, ie, interventions immediately after the trauma. Evidence available starting from current concepts and contemporary research of potential secondary prevention interventions are presented. Common practices in the aftermath of trauma such as debriefing and benzodiazepines need to be carefully considered, taking into account their potential harm to the spontaneous recovery process, and the trajectory of PTSD, and not only judging them according to their immediate (comforting) effects. A discussion of the balance required between aiding recovery but not interfering with the potent natural resolution of symptoms (that is expected in most cases), along with potential avenues of future research, are presented. Results of a small pilot study with a single intervention of hydrocortisone immediately after trauma appear to be promising, and clearly indicate the need for further studies.

scholarly journals 0817 Abnormal REM Sleep Atonia Control In Patients With Chronic Post-traumatic Stress Disorder

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A310-A312
Author(s):  
J Feemster ◽  
T Steele ◽  
Y Tao ◽  
S Rivera ◽  
T Gossard ◽  
...  
Keyword(s):  
Rem Sleep ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Rem Sleep Behavior Disorder ◽  
Psychiatric Disease ◽  
Post Traumatic Stress ◽  
Sleep Behavior ◽  
Unique Biology ◽  
Post Traumatic

Abstract Introduction Post-traumatic stress disorder (PTSD) is characterized by persistent mental and emotional stress following one or more significant physical or psychological traumatic incidents earlier in life. Vivid recall of the events, including traumatic nightmares, and prominent sleep disturbance are usual in PTSD. Previous studies have suggested that PTSD may share some clinical features with idiopathic REM sleep behavior disorder (iRBD) including altered REM sleep without atonia (RSWA) levels. Our group has previously found evidence for altered RSWA control in patients with psychiatric disease, including a pilot sample of PTSD patients with iRBD. We aimed to comparatively analyze RSWA levels between patients with PTSD, PTSD and RBD (PTSD+RBD), iRBD, and controls. Methods We selected 18 PTSD, 18 PTSD+RBD, 15 iRBD, and 51 healthy control patients matched for age and sex from the Mayo Clinic Center for Sleep Medicine’s polysomnography database for RSWA quantification. RSWA amounts in the submentalis (SM) and anterior tibialis (AT) were quantitatively analyzed as a percentage of REM sleep duration, in accordance with previously published methods. Non-parametric analyses were performed to compare RSWA, patient demographics, and PSG data across groups. Significance was set at p < 0.016. Results Patients with PTSD had significantly higher RSWA than controls in all RSWA density measures (p < 0.016 for all). All measures of RSWA, excluding average SM duration, were significantly greater in PTSD+RBD patients compared with controls (p < 0.016 for all). Within the PTSD group, patients on antidepressants did not have significantly higher RSWA in any of the measures. PTSD+RBD patients had significantly higher SM Phasic, AT Any, SM+AT Any, and Tonic RSWA measures than PTSD patients (p < 0.016 for all). Conclusion PTSD patients have significantly higher RSWA than controls, with PTSD+RBD patients having higher RSWA levels than PTSD patients. These data provide the first evidence for abnormal RSWA control in patients with chronic PTSD. This provides evidence of a unique biology in PTSD that could imply a future risk for neurodegenerative disease in PTSD similar to RBD patients. Further prospective studying will need to be performed on patients with PTSD to understand the unique biology. Support  

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