Sleep events among veterans with combat-related posttraumatic stress disorder.
T A Mellman, R Kulick-Bell, L E Ashlock, B Nolan
American Journal of Psychiatry January 1995 DOI: 10.1176/ajp.152.1.110 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational study combining survey, sleep diary, and polysomnography Peer reviewed |
|---|---|
| Sample size | 58 |
| Population | Combat veterans with and without PTSD, including hospitalized inpatients and medication-free veterans, plus healthy comparison subjects not exposed to combat |
| Topics | PTSD |
| Key findings | Veterans with PTSD most commonly reported recurrent awakenings, threatening dreams, thrashing, and awakenings with startle or panic. Polysomnography showed longer time awake and more micro-awakenings, with a trend toward more body and limb movements. Symptomatic awakenings tended to follow REM sleep, and the authors argue that PTSD intrudes highly aroused behaviors and states into sleep, partly conditioned to REM. |
Abstract
Sleep disturbances are important features of posttraumatic stress disorder (PTSD); however, the published data characterizing PTSD sleep phenomena are limited. The authors report on the phenomenology and physiological correlates of symptomatic sleep events in PTSD. The study data included survey results that addressed sleep symptoms during the past month in combat veterans with and without PTSD (N = 58), sleep diary records of awakenings from combat veterans with PTSD hospitalized on an inpatient rehabilitation unit (N = 52), and overnight polysomnography recordings obtained from 21 medication-free combat veterans with PTSD and eight healthy comparison subjects not exposed to combat. Recurrent awakenings, threatening dreams, thrashing movements during sleep, and awakenings with startle or panic features represented the most prevalently reported sleep-related symptoms. Laboratory findings of longer time awake, micro-awakenings, and a trend for patients to exhibit body and limb movements during sleep are consistent with the subjectively reported symptom profile. Prospectively assessed symptomatic awakenings featured startle or panic symptoms or anxiety related to threatening dreams. Laboratory findings revealed a trend for the symptomatic awakenings (with and without dream recall) to be disproportionately preceded by REM sleep, and the two recorded awakenings with objective physiological arousal were preceded by REM. PTSD features intrusions into sleep of more highly aroused behaviors and states, which appear partially conditioned to REM sleep.
Comparable studies
Other cross-sectional and survey studies on PTSD, most cited first.
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|---|---|---|---|
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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 26
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- Studies with lucid dreaming as add-on therapy to Gestalt therapy Acta Neurologica Scandinavica January 30, 2015
- Lucid dreaming treatment for nightmares: A series of cases. Dreaming September 1, 2003
- The effects of suppressing intrusive thoughts on dream content, dream distress and psychological parameters Journal of Sleep Research May 16, 2013
- Relationship between dissociative experiences, abnormal sleep experiences, and sleep quality in undergraduate students Dusunen Adam: The Journal of Psychiatry and Neurological Sciences June 30, 2010
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