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Sleep in lifetime posttraumatic stress disorder: a community-based polysomnographic study
Naomi Breslau1, Thomas Roth, Eleni Burduvali
1Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing 48824, USA. breslau@epi.msu.edu
Archives of General Psychiatry
|May 5, 2004
Summary
Posttraumatic stress disorder (PTSD) is linked to sleep complaints, but objective polysomnography shows no significant disturbances. However, individuals with PTSD experience more brief arousals during REM sleep, potentially explaining their subjective complaints.
Area of Science:
- Sleep Medicine
- Psychiatry
- Trauma Studies
Background:
- Sleep disturbances are a common complaint in posttraumatic stress disorder (PTSD), recognized in diagnostic criteria.
- Previous polysomnographic studies on small, trauma-specific samples yielded inconsistent findings regarding sleep disturbances in PTSD.
Purpose of the Study:
- To objectively evaluate polysomnographic sleep disturbances in a representative cohort of young adults with posttraumatic stress disorder (PTSD).
Main Methods:
- A 10-year follow-up study of young-adult community residents identified a subset for polysomnography over two nights.
- Participants included individuals with trauma exposure, PTSD diagnosis, and a random subsample (n=292, including 71 with PTSD).
- Standard polysomnography assessed sleep, including induction, maintenance, staging, fragmentation, and movement disorders, alongside the Multiple Sleep Latency Test.
Main Results:
- No objective differences in standard sleep disturbance measures were found between individuals with PTSD and control groups.
- Individuals with PTSD exhibited higher rates of brief arousals specifically during rapid eye movement (REM) sleep.
- Sleep stage shifts to lighter sleep and wakefulness were significantly more prevalent in REM compared to non-REM sleep.
Conclusions:
- Objective polysomnography did not reveal clinically significant sleep disturbances in individuals with PTSD.
- An increased frequency of brief REM sleep arousals was observed in the PTSD group.
- Subjective sleep complaints in PTSD may stem from heightened perception of these brief REM sleep arousals.