The extreme nocturnal manifestation of trauma: Trauma associated sleep disorder

Trauma associated sleep disorder (TSD) is likely a novel REM sleep related parasomnia which develops after trauma associated with sleep deprivation and/or disruption. Patients present with trauma related nightmares and disruptive nocturnal behaviors. These are the most profound sleep disturbances incited by trauma but are not well characterized. This may in part result from their rare occurrence in monitored settings, which contrasts distinctly with patient’s self-reported nocturnal experiences. Disruptive nocturnal behaviors consisting of vocalizations, autonomic discharges of tachycardia, tachypnea, night sweats, and non-specific movements as well as dream enactment behavior are reported. Recognizing the clinical features of TSD and classifying it as a distinct parasomnia are paramount to treating the extreme nocturnal distress characteristic of this disorder.