Trauma-associated sleep disorder: A posttraumatic stress/REM sleep behavior disorder mash-up?

John C. Feemster, Kevin L. Smith, Stuart J. McCarter, Erik K. St Louis

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Trauma-associated sleep disorder (TASD) is a parasomnia sharing characteristics of post-traumatic stress disorder (PTSD) and REM sleep behavior disorder (RBD) including dream-enactment behavior (DEB). Here we report REM sleep without atonia (RSWA) and other neurological features in a patient with complex vocal and motor DEB following traumatic combat military exposure. Post-discharge, his wife observed frequent yelling and jerking during sleep with dream mentation reminiscent of traumatic military experiences. He was initially diagnosed with PTSD. Polysomnography demonstrated RSWA and severe obstructive sleep apnea treated with nasal continuous positive airway pressure (CPAP). Dream-enactment behavior severity and frequency was reduced, but still persisted despite nasal CPAP and sequential ?uoxetine, escitalopram, prazosin, and melatonin trials. Our case demonstrated overlapping clinical features of PTSD and RBD with polysomnography features of RSWA supportive of idiopathic RBD but no 'soft signs' suggesting underlying synucleinopathy. Longitudinal follow-up of larger case series must clarify whether TASD consistently manifests REM sleep atonia loss and determine the phenoconversion risk for synucleinopathy neurodegeneration.

Original languageEnglish (US)
Pages (from-to)345-349
Number of pages5
JournalJournal of Clinical Sleep Medicine
Volume15
Issue number2
DOIs
StatePublished - 2019

Keywords

  • Polysomnography
  • Posttraumatic stress disorder
  • REM sleep behavior disorder
  • Trauma associated sleep disorder

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Trauma-associated sleep disorder: A posttraumatic stress/REM sleep behavior disorder mash-up?'. Together they form a unique fingerprint.

  • Cite this