Recent Advancements in Treating Sleep Disorders in Co-Occurring PTSD

Colvonen, Peter J.; Straus, Laura D.; Stepnowsky, Carl; McCarthy, Michael J.; Goldstein, Lizabeth A.; Norman, Sonya B.

doi:10.1007/s11920-018-0916-9

Cited by 91 publications

(59 citation statements)

References 146 publications

(168 reference statements)

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“…There is preliminary evidence for the efficacy of cognitive behavioural therapy for insomnia (CBT-I) as an effective intervention in psychiatric populations (Wu, Appleman, Salazar, & Ong, 2015 ). It is currently recommended as the best treatment option for sleep disturbance in PTSD (Colvonen et al, 2018 ; Miller, Brownlow, & Gehrman, 2020 ); however, it has not received significant attention in this context (Taylor & Pruiksma, 2014 ) and the optimal ordering with treatment for the waking symptoms of PTSD, is unknown (Colvonen et al, 2018 ). Preliminary studies of integrated treatment approaches that target both sleep and other symptoms of PTSD have shown promise (Colvonen, Drummond, Angkaw, & Norman, 2019 ; Miller et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Sleep disturbance in post-traumatic stress disorder (PTSD): a systematic review and meta-analysis of actigraphy studies

Lewis

Kitchiner

et al. 2020

European Journal of Psychotraumatology

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Background: Sleep disturbance has been described as a 'hallmark' symptom of posttraumatic stress disorder (PTSD). Although there are robust findings of self-reported sleep disturbance in PTSD, evidence of sleep disturbance measured using actigraphy is less certain. Objective: To conduct a systematic review and meta-analysis to determine whether there are any significant differences between individuals with and without PTSD in actigraphderived sleep measures. Method: Case-control studies comparing participants with current PTSD to those without PTSD were eligible for inclusion. Sleep parameters of interest were: (1) total sleep time; (2) sleep onset latency; (3) wake after sleep onset (WASO); and (4) sleep efficiency. Data were meta-analysed as standardised mean differences (SMDs) and potential sources of heterogeneity were explored through meta-regression. Six actigraphy studies with 405 participants were included. Results: There was no evidence of a statistically significant difference between those with and without PTSD in total sleep time (SMD 0.09, 95%CI −0.23 to 0.42); WASO (SMD 0.18, 95% CI −0.06 to 0.43); sleep latency (SMD 0.32, 95%CI −0.04 to 0.69); or sleep efficiency (SMD −0.28, 95%CI −0.78 to 0.21). Conclusions: Further high-quality research is required to determine whether there is a true difference in sleep between those with and without PTSD. Perturbación del sueño en el Trastorno de Estrés Postraumático (TEPT): una revisión sistemática y metaanálisis de estudios de actigrafía Antecedentes: La perturbación del sueño se ha descrito como un síntoma 'distintivo' del trastorno de estrés postraumático (TEPT). Aunque existen hallazgos sólidos de trastornos del sueño en el TEPT a través de auto-reportes, la evidencia de éstos medidos con el uso de actigrafía es más incierta. Objetivo: Realizar una revisión sistemática y un metanálisis para determinar si hay diferencias significativas entre los individuos con y sin TEPT en medidas de sueño derivadas de la actigrafía. Método: Los estudios de casos y controles incluidos como elegibles fueron aquéllos que compararon participantes con TEPT en curso con aquellos participantes sin TEPT. Los parámetros de sueño de interés fueron: (1) tiempo total del sueño; (2) latencia del inicio del sueño; (3) vigilia después del inicio de sueño (wake after sleep onset, WASO, en su sigla en inglés); y (4) eficiencia del sueño. Los datos fueron meta-analizados como diferencias de medias estandarizadas (DME) y se exploraron las posibles fuentes de heterogeneidad mediante metarregresión. Se incluyeron seis estudios de actigrafía con 405 participantes. Resultados: No hubo evidencia de una diferencia estadísticamente significativa entre aquellos con y sin TEPT en el tiempo total del sueño (DME 0.09, IC 95%: −0,23 a 0,42); WASO (DME 0.18, IC 95% −0.06 a 0.43); latencia del sueño (SMD 0.32, IC 95% −0.04 a 0.69); o eficiencia del sueño (SMD −0.28, IC 95% −0.78 a 0.21). Conclusiones: Se requieren futuras investigaciones de alta calidad para determinar si existe una verdadera diferencia ...

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Section: Discussionmentioning

confidence: 99%

Sleep disturbance in post-traumatic stress disorder (PTSD): a systematic review and meta-analysis of actigraphy studies

Lewis

Kitchiner

et al. 2020

European Journal of Psychotraumatology

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“…Accordingly, interventions promoting restful sleep in the immediate aftermath of trauma may bear the potential to reduce the risk for PTSD. Although promising, sleep-based interventions such as cognitive behavioral therapy for insomnia have rarely been investigated as preventive treatment after trauma (Colvonen et al, 2018). The current state of research underscores that such investigations are both timely and warranted.…”

Section: Discussionmentioning

confidence: 99%

Differential effects of sleep on explicit and implicit memory for potential trauma reminders: findings from an analogue study

Sopp

Brueckner

Schäfer

et al. 2019

European Journal of Psychotraumatology

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Background: Recent findings suggest that disruptions of sleep-related memory processing are involved in the development of posttraumatic stress symptoms. More specifically, exposure to an analogue traumatic event resulted in fewer intrusive memories, when it was followed by sleep instead of continued wakefulness. However, competing evidence suggests that sleep deprivation may reduce intrusive re-experiencing. To address these conflicting accounts, we examined how sleepas opposed to partial sleep deprivationmodulates explicit and implicit trauma memory using an analogue procedure. Methods: Healthy participants (N = 41) were assigned to a Sleep or Partial sleep deprivation group. Prior to nocturnal sleep, both groups were exposed to "traumatic" picture stories. After sleep or partial sleep deprivation, participants were subjected to tests of explicit and implicit memory for potential trauma reminders. Thereafter, participants completed an intrusion triggering task that was embedded in a distractor task. Results: Analyses revealed higher explicit memory for potential trauma reminders after sleep as compared to partial sleep deprivation. No group differences were found for implicit memory. Participants responded with fewer intrusions after sleep than following partial sleep deprivation. Conclusions: The current findings support a protective role of sleep in trauma memory processing, which may be evident after the first night of sleep post-trauma. Although more research is needed, our results corroborate the importance of promoting restful sleep in trauma-exposed individuals.

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“…Several studies found difficulty in sleep onset and maintenance to be the most frequently reported symptom of posttraumatic stress disorder (PTSD; e.g., Pruiksma et al, 2016). Upwards of 90% of individuals with PTSD report difficultly sleeping and 35–61% of individuals with PTSD meet diagnostic criteria for insomnia (Colvonen et al, in press). Insomnia severity is associated with greater severity of PTSD symptoms, poorer quality of life, and worse daily functioning (e.g., Martindale, Morissette, Rowland, & Dolan, 2017; Morgan et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Insomnia severity is associated with greater severity of PTSD symptoms, poorer quality of life, and worse daily functioning (e.g., Martindale, Morissette, Rowland, & Dolan, 2017; Morgan et al, 2017). Reviews of studies that examine sleep during PTSD treatment suggest that while sleep does improve over the course of successful PTSD treatment, upwards of 80% still report clinically significant insomnia following treatment (Colvonen et al, in press). This is particularly concerning given that there are converging lines of evidence suggesting that insomnia may compromise underlying mechanisms used in trauma-focused PTSD treatment (e.g., Belleville, Guay, & Marchand, 2011; Gutner, Casement, Gilbert, & Resick, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…In a review of PTSD treatment studies that tracked sleep, Colvonen et al (in press) suggest that while sleep does improve over the course of treatment, it tends to remain above the clinical cut off for disturbed sleep. For example, in a study of active duty military personnel randomized to group Cognitive Processing Therapy (CPT) or group Present Centered Therapy (PCT; Pruiksma et al, 2016), sleep disturbance was the most frequently reported symptom of PTSD both before and after treatment.…”

Section: Introductionmentioning

confidence: 99%

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Piloting cognitive–behavioral therapy for insomnia integrated with prolonged exposure.

Colvonen¹,

Drummond²,

Angkaw³

et al. 2019

Psychological Trauma: Theory, Research, Practice, and Policy

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Recent Advancements in Treating Sleep Disorders in Co-Occurring PTSD

Cited by 91 publications

References 146 publications

Sleep disturbance in post-traumatic stress disorder (PTSD): a systematic review and meta-analysis of actigraphy studies

Sleep disturbance in post-traumatic stress disorder (PTSD): a systematic review and meta-analysis of actigraphy studies

Differential effects of sleep on explicit and implicit memory for potential trauma reminders: findings from an analogue study

Piloting cognitive–behavioral therapy for insomnia integrated with prolonged exposure.

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