Trauma Associated Sleep Disorder: Clinical Developments 5 Years After Discovery

Area of Science:

• Neurology
• Sleep Medicine
• Psychiatry

Background:

• Nightmares are common in trauma survivors but often underreported.
• Trauma-related nightmares (TRN) can be associated with disruptive nocturnal behaviors (DNB), suggesting a distinct sleep disorder.

Purpose of the Study:

• To review evidence supporting Trauma Associated Sleep Disorder (TASD) as a novel parasomnia.
• To define the clinical and polysomnographic (PSG) characteristics of TASD.
• To explore precipitating factors, differential diagnosis, therapy, and research directions for TASD.

Main Methods:

• Review of recent scientific literature on nightmares, sleep disorders, and trauma.
• Analysis of clinical and polysomnographic (PSG) data related to TASD.
• Development of diagnostic and therapeutic strategies for TASD.

Main Results:

• TRN are frequently linked with DNB, supporting the concept of TASD.
• Ambulatory monitoring shows autonomic changes during disturbed dreaming in TASD.
• TRN can occur in both REM and NREM sleep, with more distressing content in REM.
• Therapy for TASD requires addressing TRN, DNB, and comorbid sleep disorders.

Conclusions:

• TASD is a unique parasomnia that develops subsequent to trauma.
• Healthcare providers should screen trauma-exposed individuals for nightmares and DNB.
• In-lab PSG is recommended for patients reporting TRN to evaluate for TASD.