Anxiety Disorders and Posttraumatic Stress Disorder

Krystal, Andrew D.; Stein, Murray B.; Szabo, Steven T.

doi:10.1016/b978-0-323-24288-2.00136-7

Cited by 5 publications

(3 citation statements)

References 141 publications

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“…Such a finding could conceivably bear relevance for REM-related phenomenology across a broad range of psychiatric conditions (eg, posttraumatic stress disorder). 69 …”

Section: Discussionmentioning

confidence: 99%

The Effects of an Afternoon Nap on Episodic Memory in Young and Older Adults

Scullin

Fairley

Decker

et al. 2017

Sleep

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Study Objectives: In young adults, napping is hypothesized to benefit episodic memory retention (eg, via consolidation). Whether this relationship is present in older adults has not been adequately tested but is an important question because older adults display marked changes in sleep and memory. Design: Between-subjects design. Setting: Sleep laboratory at Emory University School of Medicine. Participants: Fifty healthy young adults (18-29) and 45 community-dwelling older adults (58-83). Intervention: Participants were randomly assigned to a 90-minute nap opportunity or an equal interval of quiet wakefulness. Measurements and Results: Participants underwent an item-wise directed forgetting learning procedure in which they studied words that were individually followed by the instruction to "remember" or "forget." Following a 90-minute retention interval filled with quiet wakefulness or a nap opportunity, they were asked to free recall and recognize those words. Young adults retained significantly more words following a nap interval than a quiet wakefulness interval on both free recall and recognition tests. There was modest evidence for greater nap-related retention of "remember" items relative to "forget" items for free recall but not recognition. Older adults' memory retention did not differ across nap and quiet wakefulness conditions, although they demonstrated greater fragmentation, lower N3, and lower rapid eye movement duration than the young adults. Conclusions: In young adults, an afternoon nap benefits episodic memory retention, but such benefits decrease with advancing age.

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“…Such a finding could conceivably bear relevance for REM-related phenomenology across a broad range of psychiatric conditions (eg, posttraumatic stress disorder). 69 …”

Section: Discussionmentioning

confidence: 99%

The Effects of an Afternoon Nap on Episodic Memory in Young and Older Adults

Scullin

Fairley

Decker

et al. 2017

Sleep

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“…Limitations to our study include the small sample recruited from one region of the United States. In addition, our sleep and respiratory results may have been influenced by methadone dose, current medication use, concurrent nonprescribed or illegal substance use, or high pain, depressive, and/or anxiety symptom burdens (Axén, 2016; Chakravorty et al, 2018; Krystal et al, 2017; Rosen et al, 2019). In particular, sleep in methadone patients is influenced by benzodiazepine use (Peles et al, 2009), and seven of our eight participants reported past benzodiazepine use.…”

Section: Discussionmentioning

confidence: 99%

“…MOUD treatments are further complicated by co-occurring disorders (Wilson et al, 2018; Yin et al, 2015) along with polysubstance use, pain, anxiety, depression, and suicide attempts (Eyler, 2013; Jones & McCance-Katz, 2019; Yin et al, 2015; Zhong et al, 2019). Comorbid pain, chronic opioid use, and mental health issues can influence sleep (Axén, 2016; Krystal et al, 2017; Rosen et al, 2019), and indeed, problems with sleep along with nighttime respiratory disturbances have been reported in individuals receiving methadone-based MOUD (Peles et al, 2006; Stein et al, 2004). Such reports are expected based on the well-documented observation that acute opioid administration can reduce respiratory rate (Montandon et al, 2016) and chronic opioid use is associated with sleep-disordered breathing (Rosen et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Nighttime Sleep and Respiratory Disturbances in Individuals Receiving Methadone to Treat Opioid Use Disorder

Finlay,

Erwin,

Skeiky

et al. 2023

UJAN

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Opioids are a leading cause of drug overdose deaths in the United States. Methadone used as medication for opioid use disorder (MOUD) reduces drug cravings and promotes abstinence. However, individuals in methadone-based MOUD treatment commonly report subjective sleep complaints and are at risk for respiratory depression from opioids. We investigated nighttime sleep and respiratory function in eight individuals (six women, two men; ages 31–68 years) in their first 90 days of methadone-based MOUD treatment. Participants underwent overnight cardiorespiratory polysomnography. Sleep and respiratory variables were characterized with descriptive statistics for comparison to reference data from similarly aged healthy adults. Although participants spent 8.1 ± 0.3 hours (mean ± SD) in bed, their total sleep time was only 6.8 ± 1.3 hours. They exhibited longer sleep latency and intermittent wakefulness. Sleep structure was irregular, with disrupted sleep cycles. Participants also displayed a decreased amount of N1 sleep and an increased amount of N3 sleep, compared with reference data. Participants showed respiratory depression, with an average apnea–hypopnea index of 16.5 ± 8.9 events per hour. Central sleep apneas comprised 69.1% ± 20.9% of the respiratory events. A Cheyne–Stokes-like breathing pattern, consisting of 30-second cycles of three central sleep apneas, was observed in 75% of participants. Our results suggest that individuals early in methadone-based MOUD treatment experience disordered sleep and respiratory disturbances. Such nighttime physiological changes may have serious long-term health consequences and contribute to unintended overdose rates. Identifying and treating MOUD individuals with sleep apnea could reduce risk of death.

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Sleep and Stress

Everly¹,

Lating²

2019

A Clinical Guide to the Treatment of the Human Stress Response

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Anxiety Disorders and Posttraumatic Stress Disorder

Cited by 5 publications

References 141 publications

The Effects of an Afternoon Nap on Episodic Memory in Young and Older Adults

The Effects of an Afternoon Nap on Episodic Memory in Young and Older Adults

Nighttime Sleep and Respiratory Disturbances in Individuals Receiving Methadone to Treat Opioid Use Disorder

Sleep and Stress

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