Psychiatry Research EG

Post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder seen in 25–30% of individuals experiencing a traumatic event [1,2]. It is estimated that 70–87% of patients with PTSD experience sleep disruption. Specifically, the traumatic event is persistently re-experienced in recurrent distressing dreams or nightmares (NMs), and the patient has ongoing symptoms of increased arousal, manifesting as difficulty in falling or remaining asleep [3]. Other sleep problems, such as periodic limb movement (PLM) disorder and sleep-disordered breathing (SDB), also appear to be more prevalent in patients with PTSD than in the general population. Having a comorbid psychiatric diagnosis may or may not increase the chances of sleep disturbance. However, such disturbances can both exacerbate and prolong PTSD, especially as sleep serves a restorative function and facilitates emotional processing [3,4]. It has become clear that sleep difficulties are common among individuals with PTSD and may even be a predictor of the development of PTSD [5]. Another view is that the sleep disturbances could be a risk factor for PTSD, or it may be a residual symptom after the treatment; further treatment of the sleep disturbance may alleviate the PTSD levels [6]. Three large-scale epidemiological studies found an B50–70% prevalence of NMs in PTSD patients [7]. Another two studies found an incidence of SDB of around 50% in persons seeking help for PTSD [8]. A recent meta-analysis study demonstrated that the most evident abnormalities in the sleep of PTSD patients that are moderated by several variables are more stage I sleep, less slow wave sleep, and higher rapid eye movements (REM) density [9]. Sleep disturbances or other factors that can reduce resiliency have been linked to an increased risk for PTSD. Similarly, case reports and studies of individuals surviving motor vehicle collisions, hurricanes, and traumatic injuries suggest that post-traumatic sleep disturbances (e.g. insomnia, NMs) can predict both the development of PTSD and the severity of symptoms [6]. In the current study, we aimed to verify the hypothesis that sleep disturbances are prominent among PTSD patients and are likely to contribute to the pathogenesis of the disorder, to determine the extent and nature of sleep disturbances in PTSD patients, and to correlate between the severity of PTSD and sleep disturbances among a group of patients with PTSD.