Sleep disturbances in posttraumatic stress disorder: Current knowledge and clinical management.
Emeric Saguin, Julie Rolling
L'Encephale June 2026 DOI: 10.1016/j.encep.2026.02.004 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Expert review Peer reviewed |
|---|---|
| Keywords | Cauchemars Insomnia Insomnie Military psychiatry Nightmares Posttraumatic stress disorder Psychiatrie militaire Sleep Sommeil Traitement Traumatisme Treatment |
| Key findings | Argues that sleep disturbances, especially insomnia and trauma-related nightmares, are central to PTSD persistence and functional impairment and should be systematically assessed and specifically treated. Describes a bidirectional relationship between PTSD symptoms and sleep, notes that polysomnographic findings are non-specific and sometimes inconclusive, and proposes that treating sleep may improve nocturnal symptoms, daytime functioning, and prognosis and offer a less stigmatizing entry into mental health care. |
Abstract
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.