Clinical description of sleep and trauma-related nightmares in a population of French active-duty members and veterans with Post-Traumatic Stress Disorder.
J. Hulot, Jean-Baptiste Roseau, D. Gomez-Mérino, M. Chennaoui, E. Saguin
L'Encephale November 1, 2022 DOI: 10.1016/j.encep.2022.10.002 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional survey Peer reviewed |
|---|---|
| Sample size | 72 |
| Population | Active-duty service members and veterans receiving treatment for PTSD in five French Military Teaching Hospitals |
| Topics | Dreaming PTSD |
| Key findings | 93.5% of military patients treated for PTSD experienced traumatic nightmares, averaging 4.7 per week, with severely reduced sleep time (5.3 hours) and high rates of replicative or partially replicative nightmares. |
Abstract
Introduction: Post-traumatic stress disorder (PTSD) is a major public health problem. The most frequent complaints in this pathology are sleep disorders and trauma-related nightmares in particular. Trauma-related nightmares are characteristic of PTSD and impact its severity insofar as they are associated with more severe, longer-lasting symptoms and resistance to first-line treatments. There are specific characteristics associated with military personnel, including overrepresentation of replicative trauma-related nightmares. The aim of this study was to provide an accurate description of sleep patterns and the characteristics of trauma-related nightmares in a population of active-duty members or veterans diagnosed with PTSD.
Methods: We recruited active-duty service members and veterans receiving treatment for PTSD in the psychiatric departments of five Military Teaching Hospitals (Hôpitaux d'Instruction des Armées, HIA) and described their sleep characteristics using a questionnaire, the Trauma-Related Nightmare Survey French version (TRNS-FR).
Results: Out of 77 patients, 72 (93.5%) who experienced traumatic nightmares were included. This population had very severe clinical manifestations of PTSD, with a mean PCL-S score of 62.6 and an estimated total sleep time of 5.3h (317min). Among these patients, 31% had replicative nightmares and 57.7% had partially replicative nightmares. Nightmares were frequent (4.7 nightmares on average over the previous week), highly realistic, and highly immersive with exacerbated symptoms during the nightmare and also upon awakening.
Discussion: Sleep quality was seriously altered among active-duty service members and veterans treated in Military Hospitals for PTSD with trauma-related nightmares. Certain criteria were identified to help characterize trauma-related nightmares: their level of replication, recurrence and the impact of these symptoms on patients' lives.
Conclusion: Long-term traumatic nightmares are a prominent feature in the symptomatology of active service members and veterans suffering from PTSD. This symptom is of particular interest as it may be a sign of changes in the patient's condition and a potential therapeutic target.
Comparable studies
Other cross-sectional and survey studies on PTSD, most cited first.
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| Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders German adolescent SUD patients aged 13–18 years at an outpatient clinic | 2022 | Cross-sectional study | n = 111 |
| Risk factors of sleep paralysis in a population of Polish students. Polish university students under 35 | 2022 | Cross-sectional survey | n = 2,553 |
| Expert opinions on implementation of MDMA-assisted therapy in Europe: critical appraisal towards training, clinical practice, and regulation. Researchers and clinicians involved in MDMA-AT clinical trials and contributors to the... | 2024 | Survey | n = 68 |
Citations in the library
Cited by 4
- Distressing dreams in trauma survivors: using a sleep diary mobile app to reveal distressing dream characteristics and their relationship to symptoms and suicidal ideation in trauma-exposed adults SLEEP Advances 2025
- Efficacy of imagery rehearsal therapy in the treatment of traumatic nightmares in youth with complex post-traumatic stress disorder. Journal of Clinical Sleep Medicine June 17, 2026
- Physiological markers of Trauma-related nightmares among military personnel suffering from PTSD: A multicenter home-recording study. Psychiatry and Clinical Neurosciences February 14, 2026
- A path model of associations between war-related exposure to trauma, nightmares, fear, insomnia, and posttraumatic stress among Ukrainian students during the Russian invasion. Psychiatry Research October 2023
Cites 2
- An Ambulatory Polysomnography Study of the Post-traumatic Nightmares of Post-traumatic Stress Disorder Sleep November 21, 2017
- Translation, Cross-Cultural Adaptation and Preliminary Validation of a French Version of the Trauma-Related Nightmare Survey (TRNS-FR) in a PTSD Veteran Population. Military Medicine April 26, 2022