Sleep in PTSD: Conceptual model and novel directions in brain-based research and interventions

Germain, Anne; McKeon, Ashlee B.; Campbell, Rebecca

doi:10.1016/j.copsyc.2016.12.004

Cited by 55 publications

(41 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If there is a true difference in sleep in those with PTSD, there is a need to determine whether this is primarily due to recurrent nightmares. If so, sleep therapies that target nightmare disorders might be the most effective option (Zak et al, 2010 ), with Imagery Rescripting Therapy (IRT) currently being the preferred psychological treatment option (Germain, McKeon, & Campbell, 2017 ; Waltman, Shearer, & Moore, 2018 ). Sleep disturbance has also been found to remain residual to therapy for PTSD (Australian Centre for Posttraumatic Mental Health, 2007 ; International Society of Traumatic Stress Studies [ISTSS], 2018 ; Pruiksma et al, 2016 ).…”

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

View full text Add to dashboard Cite

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 ...

show abstract

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

View full text Add to dashboard Cite

show abstract

“…Fatigue and psychiatric conditions including depression, anxiety, and post-traumatic stress disorder (PTSD) were reported to be associated with sleep disturbances (Germain et al 2017;Gould et al 2018;Steiger and Pawlowski 2019;Wendt et al 2019). We assessed fatigue, fatigue, anxiety, and PTSD to control the effect of those comorbidities on sleep disturbance.…”

Section: Variables For Analysismentioning

confidence: 99%

The relationship between the pattern of shift work and sleep disturbances in Korean firefighters

Jang

Jeong

Ahn

et al. 2019

Int Arch Occup Environ Health

View full text Add to dashboard Cite

Purpose Sleep disturbances are prevalent in firefighters, but the relationship between patterns of shift work and sleep disturbances has not yet been investigated. Here, this relationship has been evaluated in Korean firefighters. Methods A cross-sectional study was conducted using an online questionnaire, which captured demographic, psychosocial and work-related characteristics. Sleep disturbance was assessed using the insomnia severity index (ISI). The relationship between insomnia and work-related factors (including type of shift work and the frequency of emergency events and off-duty work which means overtime work on off days) was analyzed. Results A total of 9810 firefighters completed the survey, representing approximately 21.5% of all Korean firefighters; data from 9738 subjects were included in the analysis. All firefighter roles were significantly associated with insomnia; the odds ratio (OR) was 2.456 (95% confidence interval [CI] 1.461-4.128) for fire suppression and 1.871 (95% CI 1.105-3.167) for the emergency medical services and rescue. However, the pattern of shift work did not show a statistically significant relationship. The OR increased along with the frequency of emergency events and off-duty work (p value for trend < 0.05). Conclusions This study found a significant association between the frequency of emergency and off-duty work and insomnia in Korean firefighters, whereas the pattern of shift work showed no significant relationship. Therefore, measures to reduce the frequency of emergency and off-duty work are required to prevent sleep disturbances in firefighters.

show abstract

“…Although sleep disturbances are symptoms of PTSD, insomnia may be best considered a co-occurring and independent disorder [27•, 28]. For instance, insomnia may precede the trauma and predict the development of PTSD [29–33].…”

Section: Relationship Between Sleep Disorders and Ptsdmentioning

confidence: 99%

Recent Advancements in Treating Sleep Disorders in Co-Occurring PTSD

Colvonen

Straus

Stepnowsky

et al. 2018

Curr Psychiatry Rep

View full text Add to dashboard Cite

PTSD treatments decrease PTSD severity and nightmare frequency, but do not resolve OSA or insomnia. Research on whether insomnia hinders PTSD treatment shows mixed results; untreated OSA does interfere with PTSD treatment. Cognitive behavioral therapy for insomnia is the recommended treatment for insomnia; however, optimal ordering with PTSD treatment is unclear. PTSD treatment may be most useful for PTSD-related nightmares. CPAP therapy is recommended for OSA but adherence can be low. Targeted treatment of sleep disorders in the context of PTSD offers a unique and underutilized opportunity to advance clinical care and research. Research is needed to create screening protocols, determine optimal order of treatment, and elucidate mechanisms between sleep and PTSD treatments.

show abstract

Sleep in PTSD: Conceptual model and novel directions in brain-based research and interventions

Cited by 55 publications

References 40 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

The relationship between the pattern of shift work and sleep disturbances in Korean firefighters

Recent Advancements in Treating Sleep Disorders in Co-Occurring PTSD

Contact Info

Product

Resources

About