Physiological markers of Trauma-related nightmares among military personnel suffering from PTSD: A multicenter home-recording study.
Psychiatry and Clinical Neurosciences February 14, 2026 DOI: 10.1111/pcn.70038 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort (case-crossover matched analysis) Peer reviewed |
|---|---|
| Sample size | 168 |
| Population | Military participants: 60 healthy controls, 34 PTSD patients without TRNs, and 74 PTSD patients with TRNs, from the SOMMEPT cohort |
| Duration | Pre-awakening autonomic activity analyzed over 10 minutes; post-awakening reactivity over a 2-minute window |
| Measures | Electroencephalography (EEG), electrodermal activity (EDA), heart rate variability, motor activity |
| Topics | Dreaming PTSD |
| Registration | NCT04581850 |
| Key findings | Trauma-related nightmares were associated with a distinctive autonomic pattern: pre-awakening sudomotor buildup (heightened electrodermal activity, earlier peaks, prolonged recovery) and reduced vagal heart rate variability compared with spontaneous awakenings in healthy controls, with weaker differences versus PTSD patients without TRNs or non-TRN awakenings. Post-awakening, TRNs elicited an abrupt surge in heart rate (accelerating within about 40 seconds and normalizing by about 2 minutes), sustained tonic electrodermal activity, longer phasic bursts, and increased motor activity during the first roughly 80 seconds. The authors argue these findings support biomarker-based detection and targeted intervention. |
Abstract
Aim: Despite being one of the most disabling symptoms of post‐traumatic stress disorder (PTSD)—disrupting sleep continuity, reinforcing hyperarousal, and worsening psychiatric comorbidity—the physiological signature of Trauma‐related nightmares (TRNs) under naturalistic sleep conditions remains poorly characterized.
Methods: We used home‐based, multi‐sensor devices from the SOMMEPT cohort to assess whether TRNs display distinct autonomic dynamics before and after awakening. TRN awakenings were self‐marked with the wristband button and validated through electroencephalography (EEG) inspection by a psychiatrist and a sleep physician. Each TRN event ( N = 412) was matched 1:1 to three control conditions: spontaneous awakenings in 60 healthy military participants, awakenings in 34 military PTSD patients without TRNs, and non‐nightmare awakenings from 74 military PTSD patients with TRNs. Pre‐awakening autonomic activity was analyzed over 10 min, and post‐awakening reactivity over a 2‐min window using nonparametric statistics with cluster‐based permutation correction.
Results: TRNs were associated with heightened sudomotor activity and reduced vagal heart rate variability compared with spontaneous awakenings in healthy controls; differences were weaker versus PTSD patients without TRNs or non‐TRN awakenings. Phasic Electrodermal activity (EDA) showed earlier peaks and prolonged recovery, while movement was lower before TRN‐related awakenings. Post‐awakening, TRNs elicited an abrupt surge: heart rate accelerated within ~40 s and normalized by ~2 min; tonic EDA remained elevated, phasic EDA bursts were longer, slower to recover, and motor activity rose during the first ~80 s.
Conclusions: TRNs display a distinctive autonomic pattern with pre‐awakening sudomotor buildup and post‐awakening cardiovascular–electrodermal surges, supporting biomarker‐based detection and targeted intervention.
Trial Registration: ClinicalTrials.gov Identifier: NCT04581850.
Comparable studies
Other randomized controlled trials on PTSD, most cited first.
Citations in the library
Cites 10
- An Ambulatory Polysomnography Study of the Post-traumatic Nightmares of Post-traumatic Stress Disorder Sleep November 21, 2017
- 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
- Clinical description of sleep and trauma-related nightmares in a population of French active-duty members and veterans with Post-Traumatic Stress Disorder. L'Encephale November 1, 2022
- The sleep physiology of nightmares in veterans with psychological trauma: Evaluation of a dominant model using participant-applied electroencephalography in the home environment. Journal of Sleep Research May 29, 2022
- 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
and 5 more in the library