Nocturnal panic and trauma

Freed, Shaari; Craske, Michelle G.; Greher, Michael R.

doi:10.1002/(sici)1520-6394(1999)9:3<141::aid-da8>3.0.co;2-5

Cited by 30 publications

(25 citation statements)

References 24 publications

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“…Agargun and Kara [1998] also suggested that those PD patients with nocturnal panic may be not only at a higher risk for comorbid depression but also suicidal behavior. Of particular interest to the current review, Freed et al [1999] found that nocturnal panickers reported higher rates of both childhood and adult trauma than PD patients without nocturnal panic attacks. Findings from the above studies provides an initial indication that those panic patients who experience nocturnal panic attacks may represent a more severe variant of PD.…”

Section: Nocturnal Panic Attacksmentioning

confidence: 96%

Sleep in post-traumatic stress disorder and panic: Convergence and divergence

Sheikh

Woodward²,

Leskin³

2003

Depress. Anxiety

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Disturbed sleep is a common clinical problem in anxiety disorders, particularly in patients with post-traumatic stress disorder (PTSD) and panic disorder (PD). Several studies have attempted to validate the subjective sleep complaints of these disorders using laboratory polysomnography. These attempts, typically focusing on PTSD or PD independently, have demonstrated inconsistent results. To our knowledge, no such studies have attempted to directly compare and contrast sleep disturbances in PTSD and PD together. Our review of the studies of subjective sleep disturbances, sleep architecture, and sleep-related biologic phenomena suggests that a comparative characterization of sleep disturbances in these two disorders is timely. Such an inference is based on our identification of several areas of convergence and divergence between PTSD and PD found in the published literature, as well as our own preliminary investigations. Specifically, PTSD and PD seem to converge on several sleep-related parameters, namely, sleep quality, presence of episodic parasomnias, and movement time. They also appear to diverge in other important sleep-related areas such as respiratory disturbances and the particular phenomenological nature of episodic parasomnias, namely nightmares or nocturnal panic attacks. Investigations focusing on such overlapping phenomena may provide groundwork for further elucidation of central fear systems underlying these two disorders. Additionally, such sleep studies have the potential to provide important insights into ongoing efforts to develop a cohesive conceptual framework into the patho-physiologies of these disorders.

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Section: Nocturnal Panic Attacksmentioning

confidence: 96%

Sleep in post-traumatic stress disorder and panic: Convergence and divergence

Sheikh

Woodward²,

Leskin³

2003

Depress. Anxiety

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“…Insomnia is one of the most commonly endorsed PTSD symptoms and is thought to arise primarily from NREM sleep disruption. Other NREM sleep disturbances often observed in trauma-exposed individuals and patients with PTSD include nocturnal panic attacks and sleep terrors (13, 15). Thus, clinical observations focusing on the nature of sleep complaints in PTSD point to a dysregulation in both REM and NREM sleep.…”

Section: Rem Sleep Disturbances In Ptsd: Hallmark or Not?mentioning

confidence: 99%

Sleep Disturbances as the Hallmark of PTSD: Where Are We Now?

Germain

2013

AJP

504

379

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The hypothesis that rapid eye movement (REM) sleep disturbances are the hallmark of posttraumatic stress disorder (PTSD), proposed by Ross and colleagues in 1989, has stimulated a wealth of clinical, preclinical, and animal studies on the role of sleep in the pathophysiology of PTSD. The present review revisits this influential hypothesis in light of clinical and experimental findings that have since accumulated. Polysomnographic studies conducted in adults with PTSD have yielded mixed findings regarding REM sleep disturbances, and they generally suggest modest and nonspecific sleep disruptions. Prospective and treatment studies have provided more robust evidence for the relationship between sleep disturbances and psychiatric outcomes and symptoms. Experimental animal and human studies that have probed the relationship between REM sleep and fear responses, as well as studies focused more broadly on sleep-dependent affective and memory processes, also provide strong support for the hypothesis that sleep plays an important role in PTSD-relevant processes. Overall, the literature suggests that disturbed REM or non-REM sleep can contribute to maladaptive stress and trauma responses and may constitute a modifiable risk factor for poor psychiatric outcomes. Clinicians need to consider that the chronic sleep disruption associated with nightmares may affect the efficacy of first-line PTSD treatments, but targeted sleep treatments may accelerate recovery from PTSD. The field is ripe for prospective and longitudinal studies in high-risk groups to clarify how changes in sleep physiology and neurobiology contribute to increased risk of poor psychiatric outcomes.

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“…A study by Uhde (1994) found that 58% of a sample of people with confirmed or probable panic disorder reported a history of NP attacks. Similarly Craske and Freed (1995), Craske and Rowe (1997) and Freed, Craske, and Greher (1999) report rates from 44% to 71% of panic patients that have experienced NP at least once. Therefore, many, possibly the majority, of persons with panic disorder who experience panic by day also panic out of sleep (Craske & Rowe, 1997).…”

Section: Introductionmentioning

confidence: 95%