Sleep disturbances in posttraumatic stress disorder: Current knowledge and clinical management

Posttraumatic stress disorder (PTSD) is a psychiatric condition frequently associated with severe sleep disturbances, especially insomnia and trauma-related nightmares (TRNs). These symptoms are among the most frequent and persistent in both civilian and military populations, yet they remain under-assessed and under-treated. This expert review aims to provide a comprehensive and updated overview of the current understanding and management of sleep disturbances in PTSD.

This work is based on a critical synthesis of recent literature, combined with clinical expertise in military psychiatry and sleep medicine. The main areas examined include epidemiological data, diagnostic classifications, clinical characteristics, and therapeutic approaches.

Sleep complaints in PTSD are often severe, with TRNs representing a key clinical hallmark. Polysomnographic findings remain non-specific and sometimes inconclusive. A bidirectional relationship is described between PTSD symptoms and sleep disturbances. Therapeutic approaches include both psychotherapeutic and pharmacological interventions, each with strengths and limitations.

Sleep disturbances in PTSD play a central role in symptom persistence and overall functional impairment. Addressing them may improve both nocturnal symptoms and daytime functioning. In psychiatric populations, treatment of sleep complaints may offer a less stigmatizing entry point into mental health care.

Sleep should be systematically assessed and specifically treated in PTSD. It constitutes a valuable clinical target and a potential lever for improving prognosis and global recovery.