Nancy Barone Kribbs

Rapid eye movement sleep disturbance in posttraumatic stress disorder

The subjective sleep disturbance in posttraumatic stress disorder (PTSD), including the repetitive, stereotypical anxiety dream, suggests dysfunctional rapid eye movement (REM) sleep mechanisms. The polysomnograms of a group of physically healthy combat veterans with current PTSD were compared with those of an age-appropriate normal control group. Tonic and phasic REM sleep measures in the PTSD subjects were elevated on the second night of recorded sleep. Increased phasic REM sleep activity persisted in the PTSD group on the subsequent night. During the study, an anxiety dream occurred in a PTSD subject in REM sleep. The results are consistent with the view that a dysregulation of the REM sleep control system, particularly phasic event generation, may be involved in the pathogenesis of PTSD. The finding of a specific disturbance of sleep unique to PTSD may have significant implications for the design of effective treatments for PTSD.

Rapid eye movement sleep changes during the adaptation night in combat veterans with posttraumatic stress disorder

BACKGROUND Hyperarousal in posttraumatic stress disorder (PTSD) is manifested during sleep as well as waking. Elevated rapid eye movement sleep (REMS) phasic activity, likely signifying central nervous system alerting, has been identified in PTSD. The authors reasoned that PTSD compared to control subjects would show particularly increased REMS phasic activity on the first night of polysomnography, with adaptation to a novel environment. METHODS First-night polysomnograms of 17 veterans with PTSD were compared with those of 11 control subjects. Sleep was also studied in subsets of both groups over two nights. RESULTS On the first night, the PTSD subjects had a higher density of rapid eye movements in the first REMS period. This measure was increased on the first compared to the second night, but there was no interaction effect between night and group. CONCLUSIONS REMS changes are again demonstrated in veterans with PTSD. Introduction to a novel environment activated a REMS phasic process, but not differentially in PTSD compared to control subjects.

Monitoring Dynamic And Reciprocal Interacting Biosystems: Sleep And Thermoregulation

In a group of ongoing field experiments designed to study circadian interactions between the thermoregulatory and sleep systems in normal sleep and insomnia, a completely ambulatory monitor is employed. Six temperature sites along with activity level are continuously read with readings being stored at 5-min intervals across the 24-hour day. Rectal and tympanic temperatures, as approximations of deep body and hypothalamic temperatures, respectively, along with four skin temperatures, right and left ventral upper chest and right and left ventral ankles, are used in these studies. Tympanic temperature shows a circadian variation similar to that of rectal temperature, with the coupling of the two being highest during the sleep phase (lowest activity level) of the 24-hour day. The skin temperatures from the ankles are representative of the isolated, peripheral shell temperature. They show a reciprocal circadian variation when compared to both rectal and tympanic temperatures, reinforcing the concept of a circadian, homeostatic regulation of deep body temperature through a reciprocal, homeostatic circadian variation in heat dissipation from deep body core to peripheral shell surface.