Trauma associated sleep disorder: A proposed parasomnia encompassing disruptive nocturnal behaviors, nightmares, and REM without atonia in trauma survivors

Vincent Mysliwiec, Brian O'Reilly, Jason Polchinski, Herbert P. Kwon, Anne Germain, Bernard J. Roth

Research output: Contribution to journalArticlepeer-review

91 Scopus citations

Abstract

Study Objectives: To characterize the clinical, polysomnographic and treatment responses of patients with disruptive nocturnal behaviors (DNB) and nightmares following traumatic experiences. Methods: A case series of four young male, active duty U.S. Army Soldiers who presented with DNB and trauma related nightmares. Patients underwent a clinical evaluation in a sleep medicine clinic, attended overnight polysomnogram (PSG) and received treatment. We report pertinent clinical and PSG findings from our patients and review prior literature on sleep disturbances in trauma survivors. Results: DNB ranged from vocalizations, somnambulism to combative behaviors that injured bed partners. Nightmares were replays of the patient's traumatic experiences. All patients had REM without atonia during polysomnography; one patient had DNB and a nightmare captured during REM sleep. Prazosin improved DNB and nightmares in all patients. Conclusions: We propose Trauma associated Sleep Disorder (TSD) as a unique sleep disorder encompassing the clinical features, PSG findings, and treatment responses of patients with DNB, nightmares, and REM without atonia after trauma.

Original languageEnglish (US)
Pages (from-to)1143-1148
Number of pages6
JournalJournal of Clinical Sleep Medicine
Volume10
Issue number10
DOIs
StatePublished - 2014
Externally publishedYes

Keywords

  • Military
  • Nightmares
  • Posttraumatic stress disorder
  • REM sleep behavior disorder
  • Veterans

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Pulmonary and Respiratory Medicine

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