Sleep Events among Veterans with Combat-Related Posttraumatic Stress Disorder

Explored the phenomenology and physiological correlates of symptomatic sleep events in posttraumatic stress disorder (PTSD). Data included survey results, sleep diary records, and overnight polysomnography recordings. Ss were 131 male Vietnam combat veterans with or without PTSD and 8 healthy Ss not exposed to combat. Ss with PTSD reported recurrent awakenings, threatening dreams, and thrashing movements during sleep and awakenings with startle or panic features. Laboratory findings of longer time awake, micro-awakenings, and a trend for Ss with PTSD to exhibit body and limb movements during sleep are consistent with the subjectively reported symptom profile. Prospectively assessed symptomatic awakenings featured startle or panic symptoms or anxiety related to threatening dreams. Lab findings reveal a trend for symptomatic awakenings to be disproportionately preceded by REM sleep, and the 2 recorded awakenings with objective physiological arousal were preceded by REM.