scholarly journals Disturbed Sleep in PTSD: Thinking Beyond Nightmares

2021 ◽  
Vol 12 ◽  
Author(s):  
Marike Lancel ◽  
Hein J. F. van Marle ◽  
Maaike M. Van Veen ◽  
Annette M. van Schagen

Sleep disturbances frequently co-occur with posttraumatic stress disorder (PTSD). Insomnia and nightmares are viewed as core symptoms of PTSD. Yet, relations between disturbed sleep and PTSD are far more complex: PTSD is linked to a broad range of sleep disorders and disturbed sleep markedly affects PTSD-outcome. This article provides a concise overview of the literature on prevalent comorbid sleep disorders, their reciprocal relation with PTSD and possible underlying neurophysiological mechanisms. Furthermore, diagnostic procedures, standard interventions—particularly first choice non-pharmacological therapies—and practical problems that often arise in the assessment and treatment of sleep disturbances in PTSD are described. Finally, we will present some perspectives on future multidisciplinary clinical and experimental research to develop new, more effective sleep therapies to improve both sleep and PTSD.

Author(s):  
Colleen E. Carney ◽  
Taryn G. Moss

Major depressive disorder (MDD) commonly occurs with several sleep disorders, including hypersomnia, breathing or limb-related sleep disturbances, and most notably chronic insomnia. A bidirectional relationship exists between sleep and mood problems, and both issues often warrant timely clinical management. However, there are several assessment- and treatment-related complexities that complicate the clinical management of such patients. For example, there are several overlapping symptoms for MDD and both insomnia and hypersomnia, and the two sleep conditions are both listed as possible symptoms in the diagnostic criteria for MDD. This has led to a well-documented problem of underrecognizing and undertreating these significant disorders in the context of MDD. Moreover, certain effective depression treatments can actually worsen the coexisting sleep disorder. Understanding and treating both disorders (i.e., MDD and the co-occurring sleep disorder) is imperative for effective clinical care. Almost all (i.e., up to 90%) of those with depression report sleep problems. This chapter provides an overview of the etiologic, assessment, and treatment issues inherent in this very large, highly prevalent group.


Author(s):  
Antje Büttner-Teleagă ◽  
Youn-Tae Kim ◽  
Tiziana Osel ◽  
Kneginja Richter

Introduction: Sleep disorders, especially insomnia, are very common in different kinds of cancers, but their prevalence and incidence are not well-known. Disturbed sleep in cancer is caused by different reasons and usually appears as a comorbid disorder to different somatic and psychiatric diagnoses, psychological disturbances and treatment methods. There can be many different predictors for sleep disturbances in these vulnerable groups, such as pre-existing sleep disorders, caused by the mental status in cancer or as side effect of the cancer treatment. Methods: A systematic literature review of 8073 studies was conducted on the topic of sleep and sleep disorders in cancer patients. The articles were identified though PubMed, PsycInfo and Web of Knowledge, and a total number of 89 publications were qualified for analysis. Results: The identified eighty-nine studies were analyzed on the topic of sleep and sleep disorders in cancer, twenty-six studies on sleep and fatigue in cancer and sixty-one studies on the topic of sleep disorders in cancer. The prevalence of sleep disturbences and/or sleep disorders in cancer was up to 95%. Discussion: Sleep disturbances and sleep disorders (such as insomnia, OSAS, narcolepsy and RLS; REM-SBD) in cancer patients can be associated with different conditions. Side effects of cancer treatment and cancer-related psychological dysfunctions can be instigated by sleep disturbances and sleep disorders in these patients, especially insomnia and OSAS are common. An evidence-based treatment is necessary for concomitant mental and/or physical states.


2017 ◽  
Vol 37 (04) ◽  
pp. 395-406 ◽  
Author(s):  
Mark Wu ◽  
Paul Rosenberg ◽  
Adam Spira ◽  
Alexandra Wennberg

AbstractApproximately half of older people report sleep disturbances, which are associated with various health conditions, including neurodegenerative disease and dementia. Indeed, 60 to 70% of people with cognitive impairment or dementia have sleep disturbances, which are linked to poorer disease prognosis. Sleep disturbances in people with dementia have long been recognized and studied; however, in the past 10 years, researchers have begun to study disturbed sleep, including sleep fragmentation, abnormal sleep duration, and sleep disorders, as risk factors for dementia. In this review the authors summarize evidence linking sleep disturbance and dementia. They describe how specific aspects of sleep (e.g., quality, duration) and the prevalence of clinical sleep disorders (e.g., sleep-disordered breathing, rapid eye movement sleep behavior disorder) change with age; how sleep parameters and sleep disorders are associated with the risk of dementia; how sleep can be disturbed in dementia; and how disturbed sleep affects dementia prognosis. These findings highlight the potential importance of identifying and treating sleep problems and disorders in middle-aged and older adults as a strategy to prevent cognitive decline and dementia. The authors also review recent evidence linking sleep disturbances to the pathophysiology underlying dementing conditions, and briefly summarize available treatments for sleep disorders in people with dementia.


2021 ◽  
pp. 1-13
Author(s):  
Franziska C. Weber ◽  
Thomas C. Wetter

Sleep disorders and nightmares are core symptoms of post-traumatic stress disorder (PTSD). The relationship seems to be bidirectional, and persistent disturbed sleep may influence the course of the disorder. With regard to sleep quality, insomnia and nocturnal anxiety symptoms, as well as nightmares and stressful dreams, are the most prominent sleep symptoms. Polysomnographic measurements reveal alterations of the sleep architecture and fragmentation of rapid eye movement sleep. In addition, sleep disorders, such as sleep-related breathing disorders and parasomnias are frequent comorbid conditions. The complex etiology and symptomatology of trauma-related sleep disorders with frequent psychiatric comorbidity require the application of multimodal treatment concepts, including psychological and pharmacological interventions. However, there is little empirical evidence on the effectiveness of long-term drug treatment for insomnia and nightmares. For nondrug interventions, challenges arise from the current lack of PTSD-treatment concepts integrating sleep- and trauma-focused therapies. Effective therapy for sleep disturbances may consequently also improve well-being during the day and probably even the course of PTSD. Whether early sleep interventions exert a preventive effect on the development of PTSD remains to be clarified in future studies.


Author(s):  
Zeba Mueed ◽  
Pankaj Kumar Rai ◽  
Mohammad A. Kamal ◽  
Nitesh Kumar Poddar

Alzheimer’s disease (AD), characterized by abnormally phosphorylated tau, paired helical filaments (PHFs), neurofibrillary tangles (NFTs), deregulated mammalian target of rapamycin (mTOR), Aβ deposits, is a multifactorial disease with sleep disorders being one of the causative agents. Therefore, we have reviewed the literature and have tried to decode the existence of positive feedback, reciprocal and a bidirectional relationship allying between sleep disturbances and AD. Much light has been thrown on the role of tau pathology and amyloid pathology in sleep pathology and its association with AD pathology. We have also discussed the role of melatonin in regulating sleep disorders and AD. The neuroprotective action of melatonin via inhibiting tau hyperphosphorylation and Aβ deposition has also been pondered upon. Moreover, astrocytes involvement in aggravating AD has also been highlighted in this review. Several therapeutic approaches aimed at improving both sleep disorders and AD have been duly discussed such as administration of antidepressants and antihistamines, immunotherapy, metal chelators, melatonin supplementation, light therapy and physical activity. Despite consistent efforts, the complete etiology concerning sleep disorder and AD is still unclear. Therefore, further research is needed to unravel the mechanism involved and also to develop strategies that may help in obstructing AD in its preclinical stage.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nader Salari ◽  
Niloofar Darvishi ◽  
Behnam Khaledi-Paveh ◽  
Aliakbar Vaisi-Raygani ◽  
Rostam Jalali ◽  
...  

Abstract Background Sleep disorders, which are among the foremost important medical care issues, are prevalent in pregnancy. The present study is a meta-analysis of the prevalence of insomnia in the third trimester of pregnancy. This study aims to systematically review the overall prevalence of insomnia in the third trimester of pregnancy through conducting a meta-analysis. Method The literature used in this meta-analysis for the topic discussed above were obtained through searching several databases, including SID, MagIran, IranDoc, Scopus, Embase, Web of Science (WoS), PubMed Science Direct and Google Scholar databases without time limitation until December 2020. Articles developed based on cross-sectional studies were included in the study. The heterogeneity of studies was investigated using the I2 index. Also, the possible effects of heterogeneity in the studied studies are investigated using meta-regression analysis. Result In 10 articles and 8798 participants aged between11–40, the overall prevalence of insomnia in the third trimester of pregnancy based on meta-analysis was 42.4% (95% CI: 32.9–52.5%). It was reported that as the sample size increases, the prevalence of insomnia in the third trimester of pregnancy increases. Conversely, as the year of research increases, the prevalence of insomnia in the third trimester of pregnancy decreases. Both of these differences were statistically significant (P < 0.05). Conclusion Insomnia was highly prevalent in the last trimester of pregnancy. Sleep disorders are neglected among pregnant women, and they are considered natural. While sleep disturbances can cause mental and physical problems in pregnant women, they can consequently cause problems for the fetus. As a result, maintaining the physical and mental health of pregnant mothers is very important. It is thus recommended that in addition to having regular visits during pregnancy, pregnant women should also be continuously monitored for sleep-related disorders.


Author(s):  
Dmitry Fedorovich Khritinin ◽  
M. A. Sumarokova ◽  
E. P. Schukina

Currently, insomnia is not only a medical, but also a social as well as an economic problem. Sleep disorders increase the risk of somatic, neurological and mental illnesses. The shift schedule has a significant impact on the employee’s health, increasing the risk of developing such disorders as metabolic syndrome, arterial hypertension and other. As a result of sleep disturbances, lipid peroxidation processes may intensify, which can lead to the disorders described above. Therefore, the prevention and treatment of sleep disorders is an important aspect of chronic diseases diagnostics. In our opinion, it is crucial to study possible sleep disorders for their timely correction. The article discusses the features of drug and non-drug treatment of sleep disorders, as well as approaches to the primary and secondary prevention of insomnia. It is recommended to begin the treatment of sleep disorders with cognitive-behavioral therapy. Cognitive-behavioral therapy for insomnia typically includes psycho-education, training in relaxation techniques, stimulation limitation method, sleep limitation therapy, and cognitive therapy. When developing recreational activities for employees with a shift work schedule, attention should be paid to work and rest regimes, prevention of fatigue and obesity, and the sleep disorders treatment. Training in sleep hygiene and improving its compliance in the target groups is regarded as a method of non-pharmacological treatment of sleep disorders and a means of primary and secondary prevention of insomnia. In our opinion, further research on the features of the prevention and treatment of insomnia in various population groups is needed. Effective primary and secondary prevention of sleep disorders will reduce the risks of developing neurological, somatic and mental diseases and significantly improve the quality of life.


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