By: Shana Hansen, Lt. Col., USAF, MC, and Shannon N. Foster, Major, USA, MC on July 18th, 2019
Sleep Disturbances Associated With Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a trauma and stress-related disorder characterized by re-experiencing, avoidance, hyperarousal and negative alterations in cognition or mood. Events that involve threat to integrity of self or others such as rape, physical assault, natural disasters and combat exposure are commonly associated with the development of PTSD.1 The lifetime prevalence of PTSD among adults in the United States ranges from 6-10%, with women being more than twice as likely to have PTSD at some point. Significantly higher estimates have been reported in combat veterans (15-30%). Rates of PTSD in veterans are higher if they were stationed in combat zones, had tours of longer than one year, experienced combat or were injured. Specifically, among veterans with deployments to Iraq and Afghanistan, 31-86% report multiple traumatic combat exposures and 11-20% endorse significant PTSD symptoms.
Sleep Disturbances Associated With PTSD
Following traumatic experiences, sleep complaints are common. Subjective and objective sleep disturbances are associated with an increased risk of meeting PTSD diagnostic criteria, and insomnia and nightmares are core diagnostic features of PTSD. Sleep terrors, sleep avoidance, nocturnal anxiety, acting out dreams, increased motor behaviors and vocalizations are also frequently reported by PTSD patients. These sleep disturbances are known to exacerbate daytime symptoms and contribute to worsened clinical outcomes.10,11 This stresses the importance of monitoring for the development of sleep disturbances in patients with trauma history and the role they may have as mediators for clinical outcomes in PTSD. Sleep disturbances in this population are often resistant to first-line PTSD treatment. Sleep-specific interventions are commonly employed to alleviate insomnia and nightmares. Effective treatment has been associated with improved daytime PTSD symptoms, depression, quality of life and subjective physical health
In the rest of this article from the Q2 2019 issue of A2Zzz, Shana Hansen, Lt. Col., USAF, MC, and Shannon N. Foster, Major, USA, MC, discuss nightmares, trauma-associated sleep disorder, insomnia and sleep-disordered breathing in this population.
This article is one of four designated CEC articles in this issue of A2Zzz. AAST members who read A2Zzz and claim their credits online by the deadline can earn 2.00 AAST Continuing Education Credits (CECs) per issue – for up to 8.00 AAST CECs per year. AAST CECs are accepted by the Board of Registered Polysomnographic Technologists (BRPT) and the American Board of Sleep Medicine (ABSM).
To earn AAST CECs, carefully read the four designated CEC articles and claim your credits online. You must go online to claim your credits by the deadline of Aug. 15, 2019.
After the successful completion of this educational activity, your certificates will be available in the My CEC Portal acknowledging the credits earned.