Sleep Disturbances in Posttraumatic Stress Disorder

By Dr. Gregg D. Jacobs

Complaints of difficulty falling and staying asleep are common amongst most patients with PTSD (posttraumatic stress disorder) and are one of the symptom criteria for this disorder. PTSD symptom criteria also include recurring distressing dreams of the traumatic event, which may suggest rapid eye movement sleep abnormalities. However, objective sleep-laboratory based studies of small samples of PTSD patients have not yielded consistent findings supporting PTSD patients' subjective complaints of disturbed sleep.

In the May 2004 (61:508-516) issue of the Archives of General Psychiatry, Dr. Naomi Breslau and colleagues conducted a large scale, community-based study of sleep in PTSD patients using sleep laboratory assessments. The study involved 71 PTSD patients who slept in the laboratory for two nights. Subjects ranged in age from 31-40 years. These PTSD patients were compared to the sleep of control subjects.

The researchers found no differences between PTSD and control subjects on measures of sleep-onset latency or wake time after sleep onset despite the fact that PTSD patients reported more problems falling and staying asleep. Furthermore, no difference was found between groups on measures of daytime alertness. Thus, objective measures of sleep did not demonstrate sleep disturbance in PTSD patients compared to controls. These findings parallel many studies on insomnia patients that have found modest disturbances in objectively measured sleep compared to subjective complaints of significantly disturbed sleep.