Customize your JAMA Network experience by selecting one or more topics from the list below.
Breslau N, Roth T, Burduvali E, Kapke A, Schultz L, Roehrs T. Sleep in Lifetime Posttraumatic Stress Disorder: A Community-Based Polysomnographic Study. Arch Gen Psychiatry. 2004;61(5):508–516. doi:https://doi.org/10.1001/archpsyc.61.5.508
Sleep complaints are common in posttraumatic stress disorder (PTSD)
and are included in the DSM criteria. Polysomnographic
studies conducted on small samples of subjects with specific traumas have
yielded conflicting results. We therefore evaluated polysomnographic sleep
disturbances in PTSD.
A representative cohort of young-adult community residents followed-up
for 10 years for exposure to trauma and PTSD was used to select a subset for
sleep studies for 2 consecutive nights and the intermediate day. Subjects
were selected from a large health maintenance organization and are representative
of the geographic area except for the extremes of the socioeconomic status
range. The subset for the sleep study was selected from the 10-year follow-up
of the cohort (n = 913 [91% of the initial sample]). Eligibility criteria
included (1) subjects exposed to trauma during the preceding 5 years; (2)
others who met PTSD criteria; and (3) a randomly preselected subsample. Of
439 eligible subjects, 292 (66.5%) participated, including 71 with lifetime
PTSD. Main outcomes included standard polysomnographic measures of sleep induction,
maintenance, staging, and fragmentation; standard measures of apnea/hypopnea
and periodic leg movement; and results of the multiple sleep latency test.
On standard measures of sleep disturbance, no differences were detected
between subjects with PTSD and control subjects, regardless of history of
trauma or major depression in the controls. Persons with PTSD had higher rates
of brief arousals from rapid eye movement (REM) sleep. Shifts to lighter sleep
and wake were specific to REM and were significantly different between REM
and non-REM sleep (F1,278 = 5.92; P =
We found no objective evidence for clinically relevant sleep disturbances
in PTSD. An increased number of brief arousals from REM sleep was detected
in subjects with PTSD. Sleep complaints in PTSD might represent amplified
perceptions of brief arousals from REM sleep.
Create a personal account or sign in to: