Nightmares and Sleep Disturbances in Children with PTSD: A Polysomnographic and Actigraphy Approach Evaluation
Rationale: Sleep disturbances (insomnia and nightmare symptoms) are the most sensitive and persistent symptoms of pediatric post-traumatic stress disorder (PTSD). Untreated, these sleep disturbances (SD) associated with PTSD are predictive of PTSD persistence and increased psychiatric complications....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/20/6570 |
| _version_ | 1797573460541571072 |
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| author | Julie Rolling Juliette Rabot Eve Reynaud Oriane Kolb Patrice Bourgin Carmen M. Schroder |
| author_facet | Julie Rolling Juliette Rabot Eve Reynaud Oriane Kolb Patrice Bourgin Carmen M. Schroder |
| author_sort | Julie Rolling |
| collection | DOAJ |
| description | Rationale: Sleep disturbances (insomnia and nightmare symptoms) are the most sensitive and persistent symptoms of pediatric post-traumatic stress disorder (PTSD). Untreated, these sleep disturbances (SD) associated with PTSD are predictive of PTSD persistence and increased psychiatric complications. The aim of this study was to evaluate sleep and circadian rhythms in children with PTSD under both laboratory and ecological conditions in comparison with a control population and to test for the first time the hypothesis that SD and circadian rhythms are positively correlated with PTSD severity and its comorbidities. Method: This prospective pilot study evaluated PTSD, SD (insomnia, nightmares), and sleep-wake rhythms in 11 children with PTSD (aged 3–18), compared with the age and sex-matched control groups. Assessment of PTSD and subjective and objective measures of sleep and sleep-wake rhythms (questionnaires, 24-h in-laboratory video-polysomnography, 15-day at-home actigraphy recording) were performed between 1 and 6 months after the traumatic event. Results: Children with PTSD had higher sleep fragmentation (increased wake-after-sleep onset, increased number of sleep stage changes) compared to controls, with a change in sleep microarchitecture (micro-arousal index at 14.8 versus 8.2, <i>p</i> = 0.039). Sleep fragmentation parameters correlated with PTSD symptomatology, insomnia, and post-traumatic nightmare severity. The within-group comparison revealed a better sleep architecture in the controlled (sleep laboratory) than in the ecological condition (at home) (total sleep time 586 versus 464 min, <i>p</i> = 0.018). Conclusions: Sleep and rhythm disturbances are strongly associated with PTSD in children. The assessment of SD in children with PTSD should be carried out systematically and preferentially under ecological conditions, and management of SD should integrate the environment (environmental design, psycho-education for the children and their parents) more fully into therapy focused on sleep and trauma. |
| first_indexed | 2024-03-10T21:09:52Z |
| format | Article |
| id | doaj.art-6e6f1cfadc1f496781114bfadbce3a5a |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T21:09:52Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-6e6f1cfadc1f496781114bfadbce3a5a2023-11-19T16:52:58ZengMDPI AGJournal of Clinical Medicine2077-03832023-10-011220657010.3390/jcm12206570Nightmares and Sleep Disturbances in Children with PTSD: A Polysomnographic and Actigraphy Approach EvaluationJulie Rolling0Juliette Rabot1Eve Reynaud2Oriane Kolb3Patrice Bourgin4Carmen M. Schroder5Department of Child and Adolescent Psychiatry, Strasbourg University Hospital, 67091 Strasbourg, FranceDepartment of Child and Adolescent Psychiatry, Strasbourg University Hospital, 67091 Strasbourg, FranceSleep Disorders Center, International Research Center for ChronoSomnology, Strasbourg University Hospital, 67091 Strasbourg, FranceDepartment of Child and Adolescent Psychiatry, Strasbourg University Hospital, 67091 Strasbourg, FranceSleep Disorders Center, International Research Center for ChronoSomnology, Strasbourg University Hospital, 67091 Strasbourg, FranceDepartment of Child and Adolescent Psychiatry, Strasbourg University Hospital, 67091 Strasbourg, FranceRationale: Sleep disturbances (insomnia and nightmare symptoms) are the most sensitive and persistent symptoms of pediatric post-traumatic stress disorder (PTSD). Untreated, these sleep disturbances (SD) associated with PTSD are predictive of PTSD persistence and increased psychiatric complications. The aim of this study was to evaluate sleep and circadian rhythms in children with PTSD under both laboratory and ecological conditions in comparison with a control population and to test for the first time the hypothesis that SD and circadian rhythms are positively correlated with PTSD severity and its comorbidities. Method: This prospective pilot study evaluated PTSD, SD (insomnia, nightmares), and sleep-wake rhythms in 11 children with PTSD (aged 3–18), compared with the age and sex-matched control groups. Assessment of PTSD and subjective and objective measures of sleep and sleep-wake rhythms (questionnaires, 24-h in-laboratory video-polysomnography, 15-day at-home actigraphy recording) were performed between 1 and 6 months after the traumatic event. Results: Children with PTSD had higher sleep fragmentation (increased wake-after-sleep onset, increased number of sleep stage changes) compared to controls, with a change in sleep microarchitecture (micro-arousal index at 14.8 versus 8.2, <i>p</i> = 0.039). Sleep fragmentation parameters correlated with PTSD symptomatology, insomnia, and post-traumatic nightmare severity. The within-group comparison revealed a better sleep architecture in the controlled (sleep laboratory) than in the ecological condition (at home) (total sleep time 586 versus 464 min, <i>p</i> = 0.018). Conclusions: Sleep and rhythm disturbances are strongly associated with PTSD in children. The assessment of SD in children with PTSD should be carried out systematically and preferentially under ecological conditions, and management of SD should integrate the environment (environmental design, psycho-education for the children and their parents) more fully into therapy focused on sleep and trauma.https://www.mdpi.com/2077-0383/12/20/6570post-traumatic stress disordersleep disturbancesnightmaresvideo-polysomnographychildren |
| spellingShingle | Julie Rolling Juliette Rabot Eve Reynaud Oriane Kolb Patrice Bourgin Carmen M. Schroder Nightmares and Sleep Disturbances in Children with PTSD: A Polysomnographic and Actigraphy Approach Evaluation Journal of Clinical Medicine post-traumatic stress disorder sleep disturbances nightmares video-polysomnography children |
| title | Nightmares and Sleep Disturbances in Children with PTSD: A Polysomnographic and Actigraphy Approach Evaluation |
| title_full | Nightmares and Sleep Disturbances in Children with PTSD: A Polysomnographic and Actigraphy Approach Evaluation |
| title_fullStr | Nightmares and Sleep Disturbances in Children with PTSD: A Polysomnographic and Actigraphy Approach Evaluation |
| title_full_unstemmed | Nightmares and Sleep Disturbances in Children with PTSD: A Polysomnographic and Actigraphy Approach Evaluation |
| title_short | Nightmares and Sleep Disturbances in Children with PTSD: A Polysomnographic and Actigraphy Approach Evaluation |
| title_sort | nightmares and sleep disturbances in children with ptsd a polysomnographic and actigraphy approach evaluation |
| topic | post-traumatic stress disorder sleep disturbances nightmares video-polysomnography children |
| url | https://www.mdpi.com/2077-0383/12/20/6570 |
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