PTSD, arousal, and disrupted (REM) sleep

Abstract

Studies on clinical symptoms have documented correlations between post-traumatic stress disorder (PTSD) and sleep disturbances, with high prevalence for subjective sleep disturbances and small-to-moderate effects regarding objective sleep parameters. Studies on cortisol responses in PTSD have been equivocal, but there is evidence that central noradrenergic levels are increased in PTSD and these may subserve fragmentation of (REM) sleep and prolong wake after sleep onset. Such REM disruptions in PTSD may impair memory consolidation and/or emotional homeostasis as REM sleep deprivation has shown to impair fear extinction consolidation. More quantitative EEG and whole-brain neuroimaging work is needed at this stage to examine the relevant neural circuitry. Understanding the effects of heightened arousal on both task performance and sleep transitions may be essential to elucidating the neurophysiological commonalities of various PTSD symptom clusters.