title: Sleep in lifetime posttraumatic stress disorder: a community-based polysomnographic study.
abstract: BACKGROUND
  Sleep complaints are common in posttraumatic stress disorder (PTSD) and are included in the DSM criteria. Polysomnographic studies conducted on small samples of subjects with specific traumas have yielded conflicting results. We therefore evaluated polysomnographic sleep disturbances in PTSD.
  
  
  METHODS
  A representative cohort of young-adult community residents followed-up for 10 years for exposure to trauma and PTSD was used to select a subset for sleep studies for 2 consecutive nights and the intermediate day. Subjects were selected from a large health maintenance organization and are representative of the geographic area except for the extremes of the socioeconomic status range. The subset for the sleep study was selected from the 10-year follow-up of the cohort (n = 913 [91% of the initial sample]). Eligibility criteria included (1) subjects exposed to trauma during the preceding 5 years; (2) others who met PTSD criteria; and (3) a randomly preselected subsample. Of 439 eligible subjects, 292 (66.5%) participated, including 71 with lifetime PTSD. Main outcomes included standard polysomnographic measures of sleep induction, maintenance, staging, and fragmentation; standard measures of apnea/hypopnea and periodic leg movement; and results of the multiple sleep latency test.
  
  
  RESULTS
  On standard measures of sleep disturbance, no differences were detected between subjects with PTSD and control subjects, regardless of history of trauma or major depression in the controls. Persons with PTSD had higher rates of brief arousals from rapid eye movement (REM) sleep. Shifts to lighter sleep and wake were specific to REM and were significantly different between REM and non-REM sleep (F(1,278) = 5.92; P =.02).
  
  
  CONCLUSIONS
  We found no objective evidence for clinically relevant sleep disturbances in PTSD. An increased number of brief arousals from REM sleep was detected in subjects with PTSD. Sleep complaints in PTSD might represent amplified perceptions of brief arousals from REM sleep.
authors.affiliation: Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing 48824, USA. breslau@epi.msu.edu
authors.forename: Naomi
authors.initials: N
authors.lastname: Breslau
authors.forename: Thomas
authors.initials: T
authors.lastname: Roth
authors.forename: Eleni
authors.initials: E
authors.lastname: Burduvali
authors.forename: Alissa
authors.initials: A
authors.lastname: Kapke
authors.forename: Lonni
authors.initials: L
authors.lastname: Schultz
authors.forename: Timothy
authors.initials: T
authors.lastname: Roehrs
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology; D015331:Cohort Studies; D015897:Comorbidity; D003625:Data Collection; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D017286:Polysomnography; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012895:Sleep, REM / Q000502:physiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology