Abnormal rapid eye movement sleep atonia control in chronic post-traumatic stress disorder

John C. Feemster; Tyler A. Steele; Kyle P. Palermo; Christy L. Ralston; Yumeng Tao; David A. Bauer; Liam Edgar; Sonia Rivera; Maxwell Walters-Smith; Thomas R. Gossard; Luke N. Teigen; Paul C. Timm; Jarrett W. Richardson; R. Robert Auger; Bhanuprakash Kolla; Stuart J. McCarter; Bradley F. Boeve; Michael H. Silber; Erik K.St Louis

doi:10.1093/sleep/zsab259

Abnormal rapid eye movement sleep atonia control in chronic post-traumatic stress disorder

John C. Feemster, Tyler A. Steele, Kyle P. Palermo, Christy L. Ralston, Yumeng Tao, David A. Bauer, Liam Edgar, Sonia Rivera, Maxwell Walters-Smith, Thomas R. Gossard, Luke N. Teigen, Paul C. Timm, Jarrett W. Richardson, R. Robert Auger, Bhanuprakash Kolla, Stuart J. McCarter, Bradley F. Boeve, Michael H. Silber, Erik K.St Louis

Neurology

Research output: Contribution to journal › Article › peer-review

Abstract

Study Objectives: Post-traumatic stress disorder (PTSD) and rapid eye movement (REM) sleep behavior disorder (RBD) share some common features including prominent nightmares and sleep disturbances. We aimed to comparatively analyze REM sleep without atonia (RSWA) between patients with chronic PTSD with and without dream enactment behavior (DEB), isolated RBD (iRBD), and controls. Methods: In this retrospective study, we comparatively analyzed 18 PTSD with DEB (PTSD+DEB), 18 PTSD without DEB, 15 iRBD, and 51 controls matched for age and sex. We reviewed medical records to determine PTSD clinical features and quantitatively analyzed RSWA. We used nonparametric analyses to compare clinical and polysomnographic features. Results: PTSD patients, both with and without DEB, had significantly higher RSWA than controls (all p <. 025, excepting submentalis phasic duration in PTSD+DEB). Most RSWA measures were also higher in PTSD+DEB than in PTSD without DEB patients (all p <. 025). Conclusions: PTSD patients have higher RSWA than controls, whether DEB is present or not, indicating that REM sleep atonia control is abnormal in chronic PTSD. Further prospective studies are needed to determine whether neurodegenerative risk and disease markers similar to RBD might occur in PTSD patients. Statement of Significance Post-traumatic stress disorder (PTSD) and isolated rapid eye movement (REM) sleep behavior disorder (iRBD) both have prominent nightmares and sleep disturbances. In this retrospective study, we comparatively analyzed REM sleep without atonia (RSWA) between chronic PTSD with and without dream enactment behavior (DEB), and iRBD patients and controls. PTSD patients had higher RSWA than controls, whether DEB was present or not. RSWA is abnormal in chronic PTSD. Further prospective studies are needed to determine whether neurodegenerative risk and disease markers may occur in PTSD patients.

Original language	English (US)
Article number	zsab259
Journal	Sleep
Volume	45
Issue number	3
DOIs	https://doi.org/10.1093/sleep/zsab259
State	Published - Mar 1 2022

Keywords

REM sleep behavior disorder
REM sleep without atonia
dream enactment behavior
post-traumatic stress disorder

ASJC Scopus subject areas

General Medicine

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10.1093/sleep/zsab259

Cite this

Feemster, J. C., Steele, T. A., Palermo, K. P., Ralston, C. L., Tao, Y., Bauer, D. A., Edgar, L., Rivera, S., Walters-Smith, M., Gossard, T. R., Teigen, L. N., Timm, P. C., Richardson, J. W., Robert Auger, R., Kolla, B., McCarter, S. J., Boeve, B. F., Silber, M. H., & Louis, E. K. S. (2022). Abnormal rapid eye movement sleep atonia control in chronic post-traumatic stress disorder. Sleep, 45(3), Article zsab259. https://doi.org/10.1093/sleep/zsab259

Feemster, JC, Steele, TA, Palermo, KP, Ralston, CL, Tao, Y, Bauer, DA, Edgar, L, Rivera, S, Walters-Smith, M, Gossard, TR, Teigen, LN, Timm, PC, Richardson, JW, Robert Auger, R, Kolla, B, McCarter, SJ, Boeve, BF, Silber, MH & Louis, EKS 2022, 'Abnormal rapid eye movement sleep atonia control in chronic post-traumatic stress disorder', Sleep, vol. 45, no. 3, zsab259. https://doi.org/10.1093/sleep/zsab259

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title = "Abnormal rapid eye movement sleep atonia control in chronic post-traumatic stress disorder",

abstract = "Study Objectives: Post-traumatic stress disorder (PTSD) and rapid eye movement (REM) sleep behavior disorder (RBD) share some common features including prominent nightmares and sleep disturbances. We aimed to comparatively analyze REM sleep without atonia (RSWA) between patients with chronic PTSD with and without dream enactment behavior (DEB), isolated RBD (iRBD), and controls. Methods: In this retrospective study, we comparatively analyzed 18 PTSD with DEB (PTSD+DEB), 18 PTSD without DEB, 15 iRBD, and 51 controls matched for age and sex. We reviewed medical records to determine PTSD clinical features and quantitatively analyzed RSWA. We used nonparametric analyses to compare clinical and polysomnographic features. Results: PTSD patients, both with and without DEB, had significantly higher RSWA than controls (all p <. 025, excepting submentalis phasic duration in PTSD+DEB). Most RSWA measures were also higher in PTSD+DEB than in PTSD without DEB patients (all p <. 025). Conclusions: PTSD patients have higher RSWA than controls, whether DEB is present or not, indicating that REM sleep atonia control is abnormal in chronic PTSD. Further prospective studies are needed to determine whether neurodegenerative risk and disease markers similar to RBD might occur in PTSD patients. Statement of Significance Post-traumatic stress disorder (PTSD) and isolated rapid eye movement (REM) sleep behavior disorder (iRBD) both have prominent nightmares and sleep disturbances. In this retrospective study, we comparatively analyzed REM sleep without atonia (RSWA) between chronic PTSD with and without dream enactment behavior (DEB), and iRBD patients and controls. PTSD patients had higher RSWA than controls, whether DEB was present or not. RSWA is abnormal in chronic PTSD. Further prospective studies are needed to determine whether neurodegenerative risk and disease markers may occur in PTSD patients.",

keywords = "REM sleep behavior disorder, REM sleep without atonia, dream enactment behavior, post-traumatic stress disorder",

author = "Feemster, {John C.} and Steele, {Tyler A.} and Palermo, {Kyle P.} and Ralston, {Christy L.} and Yumeng Tao and Bauer, {David A.} and Liam Edgar and Sonia Rivera and Maxwell Walters-Smith and Gossard, {Thomas R.} and Teigen, {Luke N.} and Timm, {Paul C.} and Richardson, {Jarrett W.} and {Robert Auger}, R. and Bhanuprakash Kolla and McCarter, {Stuart J.} and Boeve, {Bradley F.} and Silber, {Michael H.} and Louis, {Erik K.St}",

note = "Publisher Copyright: {\textcopyright} 2021 The Author(s) 2021.",

year = "2022",

month = mar,

day = "1",

doi = "10.1093/sleep/zsab259",

language = "English (US)",

volume = "45",

journal = "Sleep",

issn = "0161-8105",

publisher = "American Academy of Sleep Medicine",

number = "3",

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T1 - Abnormal rapid eye movement sleep atonia control in chronic post-traumatic stress disorder

AU - Feemster, John C.

AU - Steele, Tyler A.

AU - Palermo, Kyle P.

AU - Ralston, Christy L.

AU - Tao, Yumeng

AU - Bauer, David A.

AU - Edgar, Liam

AU - Rivera, Sonia

AU - Walters-Smith, Maxwell

AU - Gossard, Thomas R.

AU - Teigen, Luke N.

AU - Timm, Paul C.

AU - Richardson, Jarrett W.

AU - Robert Auger, R.

AU - Kolla, Bhanuprakash

AU - McCarter, Stuart J.

AU - Boeve, Bradley F.

AU - Silber, Michael H.

AU - Louis, Erik K.St

PY - 2022/3/1

Y1 - 2022/3/1

N2 - Study Objectives: Post-traumatic stress disorder (PTSD) and rapid eye movement (REM) sleep behavior disorder (RBD) share some common features including prominent nightmares and sleep disturbances. We aimed to comparatively analyze REM sleep without atonia (RSWA) between patients with chronic PTSD with and without dream enactment behavior (DEB), isolated RBD (iRBD), and controls. Methods: In this retrospective study, we comparatively analyzed 18 PTSD with DEB (PTSD+DEB), 18 PTSD without DEB, 15 iRBD, and 51 controls matched for age and sex. We reviewed medical records to determine PTSD clinical features and quantitatively analyzed RSWA. We used nonparametric analyses to compare clinical and polysomnographic features. Results: PTSD patients, both with and without DEB, had significantly higher RSWA than controls (all p <. 025, excepting submentalis phasic duration in PTSD+DEB). Most RSWA measures were also higher in PTSD+DEB than in PTSD without DEB patients (all p <. 025). Conclusions: PTSD patients have higher RSWA than controls, whether DEB is present or not, indicating that REM sleep atonia control is abnormal in chronic PTSD. Further prospective studies are needed to determine whether neurodegenerative risk and disease markers similar to RBD might occur in PTSD patients. Statement of Significance Post-traumatic stress disorder (PTSD) and isolated rapid eye movement (REM) sleep behavior disorder (iRBD) both have prominent nightmares and sleep disturbances. In this retrospective study, we comparatively analyzed REM sleep without atonia (RSWA) between chronic PTSD with and without dream enactment behavior (DEB), and iRBD patients and controls. PTSD patients had higher RSWA than controls, whether DEB was present or not. RSWA is abnormal in chronic PTSD. Further prospective studies are needed to determine whether neurodegenerative risk and disease markers may occur in PTSD patients.

AB - Study Objectives: Post-traumatic stress disorder (PTSD) and rapid eye movement (REM) sleep behavior disorder (RBD) share some common features including prominent nightmares and sleep disturbances. We aimed to comparatively analyze REM sleep without atonia (RSWA) between patients with chronic PTSD with and without dream enactment behavior (DEB), isolated RBD (iRBD), and controls. Methods: In this retrospective study, we comparatively analyzed 18 PTSD with DEB (PTSD+DEB), 18 PTSD without DEB, 15 iRBD, and 51 controls matched for age and sex. We reviewed medical records to determine PTSD clinical features and quantitatively analyzed RSWA. We used nonparametric analyses to compare clinical and polysomnographic features. Results: PTSD patients, both with and without DEB, had significantly higher RSWA than controls (all p <. 025, excepting submentalis phasic duration in PTSD+DEB). Most RSWA measures were also higher in PTSD+DEB than in PTSD without DEB patients (all p <. 025). Conclusions: PTSD patients have higher RSWA than controls, whether DEB is present or not, indicating that REM sleep atonia control is abnormal in chronic PTSD. Further prospective studies are needed to determine whether neurodegenerative risk and disease markers similar to RBD might occur in PTSD patients. Statement of Significance Post-traumatic stress disorder (PTSD) and isolated rapid eye movement (REM) sleep behavior disorder (iRBD) both have prominent nightmares and sleep disturbances. In this retrospective study, we comparatively analyzed REM sleep without atonia (RSWA) between chronic PTSD with and without dream enactment behavior (DEB), and iRBD patients and controls. PTSD patients had higher RSWA than controls, whether DEB was present or not. RSWA is abnormal in chronic PTSD. Further prospective studies are needed to determine whether neurodegenerative risk and disease markers may occur in PTSD patients.

KW - REM sleep behavior disorder

KW - REM sleep without atonia

KW - dream enactment behavior

KW - post-traumatic stress disorder

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Abnormal rapid eye movement sleep atonia control in chronic post-traumatic stress disorder

Abstract

Keywords

ASJC Scopus subject areas

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