What were you doing on 9.11.2001.? If you are a member of
Dr. Scullin's The Science of Sleep Course, you probably are not older than 22
years old and in fact are likely younger than that...I was in first grade, Mrs.
Flusche's class, and had no concept of what was happening other than my
observation of the distressed expression on my teacher's face. Mrs.
Flusche was a "smiley," gregarious, middle-aged woman, who -- looking
back -- really loved her job. I remember
seeing her leave the room for a minute then returning with a totally different
demeanor. To a first grader, the look was simply one of sadness; little
did I know exactly how serious the situation was for the United States. I
remember her stating plainly "there are some bad guys doing bad things..."
I wonder how my sleep was that night? Probably unaffected as I was
unaware of the true gravity of events that day.
Here I examine a review article titled “Sleep Disturbances in the Wake
of Traumatic Events” by Dr. Peretz Lavie.
According to Dr.
Lavie, traumatic events can and do indeed cause sleep disturbances as such
symptoms characterize PTSD. Unfortunately, physicians diagnose veterans
and those who have experienced traumatic, life threatening events like 9/11 too
often for a sleep health expert's comfort.
Examples of PTSD patients named in the article include Japanese
imprisonment survivor as well as Holocaust survivors. Two subjective sleep-related aspects are
included for diagnostic guidance in the DSM-IV (psychological Diagnostic and
Statistical Manual IV): the reported re-experiencing of the traumatic events in
the form of nightmares (1), and difficulty in initiating and maintaining sleep
(2). Dr.
Lavie notes that sleep disturbances can occur even in the clinical
absence of PTSD. Objective findings
include severely disturbed patterns, longer sleep onset latency (SOL, a measure
of the amount of time one requires to fall asleep), shorter total sleep
duration/ time (TST), and recurrent awakenings during REM sleep (Lavie, 2001). Interestingly, increased frequency of rapid
eye movements and muscle twitches during REM are noted in patients with PTSD,
as well as increased rates of gross body movements and periodic leg movements
(associated with subjectively characterized “light” sleep).
How are
we to react to these findings? Let us
note that sleep disturbances are both common and considered normal in the
immediate aftermath of a traumatic event.
Additionally, in many cases, sleep problems indicate the presence of
other health problems instead of being side effects of an issue already present
(i.e. a PTSD diagnosis). Behavioral and
pharmacologic interventions both prove to be helpful in managing sleep
problems, especially those that stem from PTSD or other trauma-related
problems. Specific interventions
mentioned by Dr. Lavie range from progressive muscle relaxation and stimulus
control to sleep restriction and paradoxical intention (engaging in feared
behaviors).
I enjoyed
the information synthesized and provided in the article but I look forward to
more research into the area of PTSD and traumatic events as they relate to
maintenance of sleep health. I know that
my sleep quality is poor simply when I am stressed, let alone that I cannot
imagine being in a constant state of stress, as is the case with PTSD. Fortunately, I have never experienced a true
life-threatening event so I cannot offer accurate personal experiences related
to this topic. However, again, I can in
fact relate to a feeling of chronic stress…I am looking at you, finals
week. Therefore, when I imagine the
adverse effects of PTSD on sleep quality, I am not surprised that those who
suffer from the disorder have poor sleep.
Since so many of us are affected by PTSD, or have valued loved ones who
suffer from it, can we work to improve the resources available for those with
PTSD to improve sleep health? We
can. Let’s move forward with more research
in this area because we already know the impact that chronic sleep deprivation
has on a person…let us not exaggerate these effects by combining sleep debt
with the already taxing symptoms of PTSD.
See my
blogs titled “You are NOT superhuman.
Get some sleep.” And “Should we rename sick days to ‘I need sleep’ days?”
for more information on sleep deprivation.
This week
I commented on Christy Ramirez’s and Taylor Phillip’s blogs.
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