Vincent Mysliwiec1, Brian O'Reilly2, Jason Polchinski2, Herbert P Kwon2, Anne Germain3, Bernard J Roth2. 1. Brian Allgood Army Community Hospital, South Korea. 2. Madigan Army Medical Center, Department of Pulmonary, Critical Care, and Sleep Medicine, Tacoma, WA. 3. University of Pittsburgh School of Medicine, Departments of Psychiatry & Psychology, Pittsburgh, PA.
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.
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.
Authors: Murray A Raskind; Elaine R Peskind; David J Hoff; Kimberly L Hart; Hollie A Holmes; Daniel Warren; Jane Shofer; James O'Connell; Fletcher Taylor; Christopher Gross; Kirsten Rohde; Miles E McFall Journal: Biol Psychiatry Date: 2006-10-25 Impact factor: 13.382
Authors: Marshall E Cates; Melanie H Bishop; Lori L Davis; Joette S Lowe; Thomas W Woolley Journal: Ann Pharmacother Date: 2004-07-13 Impact factor: 3.154