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

To characterize the clinical, polysomnographic and treatment responses of patients with disruptive nocturnal behaviors (DNB) and nightmares following traumatic experiences. A case series of four young male, active duty U.S. Army Soldiers who presented with DNB and trauma related nightmares. Patients...

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Bibliographic Details
Published in:Journal of clinical sleep medicine 2014-10, Vol.10 (10), p.1143-1148
Main Authors: Mysliwiec, Vincent, O'Reilly, Brian, Polchinski, Jason, Kwon, Herbert P, Germain, Anne, Roth, Bernard J
Format: Article
Language:English
Subjects:
Adrenergic alpha-1 Receptor Antagonists - therapeutic use
Adult
Continuous Positive Airway Pressure - methods
Dreams - drug effects
Dreams - psychology
Humans
Male
Mental Disorders - complications
Mental Disorders - psychology
Military Personnel - psychology
Muscle Tonus
New Research
Parasomnias - complications
Parasomnias - drug therapy
Parasomnias - psychology
Polysomnography - methods
Prazosin - therapeutic use
Sleep Wake Disorders - complications
Sleep Wake Disorders - psychology
Sleep Wake Disorders - therapy
Sleep, REM - drug effects
Sleep, REM - physiology
Somnambulism - complications
Somnambulism - drug therapy
Somnambulism - psychology
Stress Disorders, Post-Traumatic - complications
Survivors - psychology
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Summary:To characterize the clinical, polysomnographic and treatment responses of patients with disruptive nocturnal behaviors (DNB) and nightmares following traumatic experiences. 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. 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. 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.
ISSN:1550-9389
1550-9397
DOI:10.5664/jcsm.4120