Study: Pregnant women with PTSD more likely to give birth early

A study found that pregnant women with PTSD are more likely to give birth early.

Pregnant women with post-traumatic stress disorder are at increased risk of giving birth prematurely, a new study from the Stanford University School of Medicine and the U.S. Department of Veterans' Affairs has found.

The study, which examined more than 16,000 births to female veterans, is the largest ever to evaluate connections between PTSD and preterm birth.

Having PTSD in the year before delivery increased a woman's risk of spontaneous premature delivery by 35 percent, the research showed. The results will be published online Nov. 6 in Obstetrics & Gynecology.

"This study gives us a convincing epidemiological basis to say that, yes, PTSD is a risk factor for preterm delivery," said the study's senior author, Ciaran Phibbs, PhD, associate professor of pediatrics and an investigator at the March of Dimes Prematurity Research Center at Stanford University. "Mothers with PTSD should be treated as having high-risk pregnancies."

Spontaneous preterm births, in which the mother goes into labor and delivers more than three weeks early, account for about six deliveries per 100 in the general population. This means that the risk imposed by PTSD translates into a total of about two additional premature babies for every 100 births. In total, about 12 babies per 100 arrive prematurely; some are born early because of medical problems for the mother or baby, rather than because of spontaneous labor.

A piece of the prematurity puzzle

"Spontaneous preterm labor has been an intractable problem," said Phibbs, noting that rates of spontaneous early labor have barely budged in the last 50 years. "Before we can come up with ways to prevent it, we need to have a better understanding of what the causes are. This is one piece of the puzzle."

Doctors want to prevent prematurity because of its serious consequences. Premature babies often need long hospitalizations after birth. They are more likely than full-term babies to die in infancy. Many of those who survive face lasting developmental delays or long-term impairments to their eyesight, hearing, breathing or digestive function.

Phibbs' team analyzed all deliveries covered by the Veterans Health Administration from 2000 to 2012, a total of 16,344 births. They found that 3,049 infants were born to women with PTSD diagnoses. Of these, 1,921 births were to women with "active" PTSD, meaning the condition was diagnosed in the year prior to giving birth, a time frame that the researchers thought could plausibly affect pregnancy.

The researchers examined the effects of several possible confounding factors. Being older, being African-American or carrying twins all increased the risk of prematurity, as extensive prior research has shown.

The researchers also looked at the effects of maternal health problems (high blood pressure, diabetes and asthma); possible sources of trauma (deployment and military sexual trauma); mental health disorders other than PTSD; drug or alcohol abuse; and tobacco dependence. However, these factors had little influence on risk for premature birth.

The effect of stress

In other words, although pregnant women with PTSD may have other health problems or behave in risky ways, it's the PTSD that counts for triggering labor early.

"The mechanism is biologic," Phibbs said. "Stress is setting off biologic pathways that are inducing preterm labor. It's not the other psychiatric conditions or risky behaviors that are driving it."

However, if a woman had been diagnosed with PTSD in the past but had not experienced the disorder in the year before giving birth, her risk of delivering early was no higher than it was for women without PTSD. "This makes us hopeful that if you treat a mom who has active PTSD early in her pregnancy, her stress level could be reduced, and the risk of giving birth prematurely might go down," said Phibbs, adding that the idea needs to be tested.

Although PTSD is more common in military veterans than the general population, a fairly substantial number of civilian women also experience PTSD, Phibbs noted. "It's not unique to the VA or to combat," he said, noting that half of the women in the study who had PTSD had never been deployed to a combat zone. "This is relevant to all of obstetrics."

The VA has already incorporated the study's findings into care for pregnant women by instructing each VA medical center to treat pregnancies among women with recent PTSD as high-risk. And Phibbs' team is now investigating whether PTSD may also contribute to the risk of the mother or baby being diagnosed with a condition that causes doctors to recommend early delivery for health reasons.

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PTSD and poor sleep

A study claims that poor sleep in people with PTSD could lead to a decrease in physical activity and an increase in obesity.

Poor sleep quality may lower physical activity in people with post-traumatic stress disorder, according to a recent study.

Researchers found that PTSD was independently associated with worse sleep quality at baseline, and participants with current PTSD at baseline had lower physical activity one year later.

Further analysis found that sleep quality completely mediated the relationship between baseline PTSD status and physical activity at the one-year follow-up, suggesting that the association of reduced sleep quality with reduced physical activity could comprise a behavioral link to negative health outcomes such as obesity.

"We found that sleep quality was more strongly associated with physical activity one year later than was having a diagnosis of PTSD," Lisa Talbot, lead author of the study and postdoctoral fellow at the San Francisco VA Medical Center and the University of California- San Francisco, said in a statement. "The longitudinal aspect of this study suggests that sleep may influence physical activity."

For the study, researchers collected and analyzed data from  the Mind Your Heart Study, a prospective cohort study of 736 outpatients recruited from two Department of Veterans Affairs (VA) medical centers. PTSD was assessed with the Clinician-Administered PTSD Scale (CAPS).  At baseline participants rated their sleep quality overall during the last month, and at baseline and again one year later they reported how physically active they have been during the last month. Of the 736 military veteran participants, 258 had current or subsyndromal PTSD.

Researchers said the results suggest that behavioral interventions to increase physical activity should include an assessment for sleep disturbance.

"The findings also tentatively raise the possibility that sleep problems could affect individuals' willingness or ability to implement physical activity behavioral interventions," Talbout said. "Sleep improvements might encourage exercise participation."

The findings were recently published in the  Journal of Clinical Sleep Medicine, which is published by the American Academy of Sleep Medicine.

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PTSD may be preventable by a drug

Researchers have found a drug that may be able to prevent PTSD.

Scientists at Yerkes National Primate Research Center, Emory University have identified a drug that appears to make memories of fearsome events less durable in mice.

The finding may accelerate the development of treatments for preventing PTSD (post-traumatic stress disorder). The drug, called osanetant, targets a distinct group of brain cells in a region of the brain that controls the formation and consolidation of fear memories.

The results were published in the journal Neuron.

"Potentially, drugs that act on this group of cells could be used to block fear memory consolidation shortly after exposure to a trauma, which would aid in preventing PTSD," says Kerry Ressler, MD, PhD, professor of psychiatry and behavioral sciences at Emory University School of Medicine and Yerkes National Primate Research Center. "PTSD is unique among psychiatric disorders in that we know when it starts -- at the time of the trauma. Finding ways to prevent its development in the first place -- in the emergency department or the battlefield -- is an important and exciting avenue of research in this area."

The first author of the paper is postdoctoral fellow Raül Andero Galí, PhD. Ressler and Andero were sifting through a list of many genes that are activated in the brains of mice after they learn to become afraid of a sound, because the sound is paired with a mild electric shock. The researchers were probing for changes in the central amygdala, a region of the brain known to regulate fear learning.

Out of thousands of genes they examined, their "top gene" was Tachykinin 2 or Tac2. The Tac2 gene was turned on more strongly during fear learning in mice that were previously exposed to a model of traumatic stress.

"The Tac2 gene is robustly activated after fear learning and belongs to a pathway that can be specifically blocked with a drug," Ressler says. "It was interesting that Tac2 is highly expressed in one particular part of the amygdala, but with low or no expression in other brain areas related to the formation of fear memories. Also, we found that the cells that express Tac2 are distinct from those other investigators had previously identified as being involved in fear expression."

Tac2 is part of a family of messengers in the nervous system known as tachykinins. Drugs that block a product encoded by Tac2's relative, Tac1, are antiemetics, often prescribed when someone is receiving chemotherapy for cancer.

Osanetant, which blocks the action of Tac2, has been tested in previous clinical studies for schizophrenia and was safe but not effective in addressing that disorder. It has not been tested in humans for PTSD prevention.

"Osanetant is a safe and well-tolerated drug in humans and could be potentially used to prevent PTSD when given shortly after trauma, although more research is needed," Andero says.

Under the influence of osanetant, mice could still learn to become afraid of a sound paired with a shock, but the mice did not freeze as much in response to the sound a day later, even if the drug was given an hour after training.

"Our goal is to specifically impair emotional memories related to a traumatic event instead of all memories associated with it. Thus, the trauma and its circumstances are remembered but the consolidation of fear memories is impaired, which could decrease the likelihood of developing fear-related disorders," Andero says.

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PTSD symptoms could be reduced by high blood pressure medications

This article discusses a hypertension medication that coincidentally also treats PTSD symptoms.

There are currently only two FDA-approved medications for the treatment of posttraumatic stress disorder (PTSD) in the United States. Both of these medications are serotonin uptake inhibitors.. Despite the availability of these medications, many people diagnosed with PTSD remain symptomatic, highlighting the need for new medications for PTSD treatment.

The renin-angiotensin system has long been of interest to psychiatry. Some of the first drugs targeting this system were the angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), commonly prescribed treatments for high blood pressure.

In the 1990's, multicenter studies evaluating ACE inhibitors suggested that they improved quality of life as well as other medical outcomes, but these medications did not prove to be sufficiently effective for the treatment of psychiatric disorders to become established treatments.

Recently, however, investigators at Emory University observed that individuals diagnosed with PTSD, and who happened to also be treated with ARBs or ACE inhibitors, exhibited fewer PTSD-like symptoms.

This led the researchers to investigate the underlying mechanisms using an animal model of PTSD in order to expand upon this clinical finding.

Dr. Paul Marvar, first author and Assistant Professor at The George Washington University, explains their findings, "Our current preclinical results show that the ARB losartan, given acutely or chronically to mice, enhances the extinction of fear memory, a process that is disrupted in individuals with PTSD. Overall these data provide further support that this class of medications may have beneficial effects on fear memory in PTSD patients."

Fear extinction is a process by which a memory associated with fear is gradually 'overwritten' in the brain by a new memory with no such association. For example, exposure therapy is a form of fear extinction, whereby repeatedly exposing a patient in a safe manner to a feared object or situation slowly reduces or eliminates their fear. A medication that could potentially enhance the extinction of fear would be welcome to the millions of individuals who continue to suffer with symptoms of PTSD.

"It is exciting to see the renin-angiotensin being explored in new ways in the search for new treatment for PTSD," commented Dr. John Krystal, Editor of Biological Psychiatry. "There is a tremendous need for more effective treatments for PTSD symptoms."

Future studies are still necessary before clinical use could be recommended, but there is hope that by targeting this pathway, it may provide a safe and powerful adjunctive novel therapy for the treatment of PTSD.

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Ecstasy may help those with Anxiety and PTSD

A study shows that the way Ecstasy acts on the brain could benefit those with anxiety and PTSD.

Researchers say they've discovered how the club drug Ecstasy acts on the brain, and their findings suggest the drug might be useful in treating anxiety and post-traumatic stress disorder.

The study included 25 volunteers who underwent two functional MRI brain scans -- one after taking Ecstasy (MDMA) and one after taking a placebo. Both times, the participants did not know which substance they had been given.

Ecstasy decreased activity in the brain's limbic system, which is involved in emotional responses. The drug also reduced communication between the brain's medial temporal lobe and medial prefrontal cortex, which is involved in emotional control, according to the study, which was published online Jan. 13 in the journal Biological Psychiatry.

These effects are the opposite of brain patterns that occur in people with anxiety, said the researchers, from Imperial College London, in England.

The researchers also found that Ecstasy increased communication between the amygdala and the hippocampus. Previous research has shown that people with post-traumatic stress disorder (PTSD) have reduced communication between these brain areas.

"We found that MDMA caused reduced blood flow in regions of the brain linked to emotion and memory," study author Dr. Robin Carhart-Harris, of the department of medicine, said in a college news release. "These effects may be related to the feelings of euphoria that people experience on the drug."

"In healthy volunteers, MDMA seems to lessen the impact of painful memories," Carhart-Harris said. "This fits with the idea that it could help patients with PTSD revisit their traumatic experiences in psychotherapy without being overwhelmed by negative emotions, but we need to do studies in PTSD patients to see if the drug affects them in the same way."

Another researcher advised caution in applying the study results to other groups of people.

"The findings suggest possible clinical uses of MDMA in treating anxiety and PTSD, but we need to be careful about drawing too many conclusions from a study in healthy volunteers," study co-leader David Nutt, a professor of neuropsychopharmacology, said in the news release. "We would have to do studies in patients to see if we find the same effects."

A recent pilot study in the United States investigated the use of MDMA along with psychotherapy in the treatment of PTSD patients and yielded positive results, the researchers said.

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Children are more likely to develop PTSD if mother has PTSD

An Israeli study finds that a child is more likely to develop PTSD if his or her mother has PTSD.

A Ben-Gurion University of the Negev (BGU) study indicates that children are more likely to develop Post Traumatic Stress Disorder (PTSD) if their mother is already afflicted.

In the study published in the Journal of Depression & Anxiety, while fewer than 10 percent (8.4 percent) of the mothers were suffering from PTSD, more than a fifth (21 percent) of their children presented PTSD symptoms. Children who developed PTSD symptoms also had more psychosomatic complaints such as constipation, diarrhea and headaches.

"This study reinforces the existing body of knowledge regarding the importance of evaluating and treating parental responses in time of stress," the researchers explain.

"Parents are often the key to understanding children's responses generally and specifically in times of stress. The study also highlights the close interrelations between 'body and soul' among children and adults."

In the study, some 160 mothers of preschool children were interviewed about symptoms exhibited by their children and their own responses during Operation Cast Lead. More than 750 rockets were fired into Southern Israel from Gaza from December 2008 to January 2009.

Working with the Preschool Psychiatric Unit at Soroka University Medical Center, the BGU researchers examined the relationship between PTSD symptoms and socio-demographic, family attributes and psychosomatic symptoms among children exposed to Grad missile attacks in Beer-Sheva, Israel.

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PTSD increases weight gain in women, study claims

A recent study shows that women who suffer from PTSD are more likely to have weight gain and be overweight or obese than women who do not have PTSD.

Women with post-traumatic stress disorder are more likely to be overweight or obese than women without the condition, a new study suggests.

According to the researchers, one in nine women will have post-traumatic stress disorder (PTSD) at some point in her life. That's twice as often as men. Women are more likely to experience traumatic events, such as rape, which carry a high risk for PTSD, the study authors said.

"PTSD is not just about mental health, but also has physical health consequences," said lead researcher Karestan Koenen, an associate professor of epidemiology at Columbia University's Mailman School of Public Health, in New York City.

Women with PTSD gain weight faster than women who do not have the condition, Koenen said. "This, in turn, has consequences for the risk of heart disease and all the adverse outcomes associated with obesity," she said.

How PTSD is linked to weight gain isn't known, Koenen said, but it may be caused by the high levels of hormones released because of stress.

These hormones are involved in a range of body processes, including metabolism, she said.

"In addition, women with PTSD may change behaviors that lead to obesity," Koenen said. "There is evidence that people under stress crave high-calorie processed foods, so it could be diet." These women also are less likely to exercise, she said.

Koenen said the same problem may exist in men suffering from PTSD, but this hasn't been well studied.

The new report was published Nov. 20 in the online edition of the journal JAMA Psychiatry.

For their research, Koenen and her colleagues collected data on more than 50,000 women who took part in the Nurses' Health Study II between 1989 and 2009. Their ages ranged from 22 to 44 at the study's start.

The women were asked about the worst trauma they experienced and if they had symptoms of PTSD. Symptoms included re-experiencing the traumatic event, feeling threatened, avoiding social situations and feeling emotionally numb. PTSD was defined as having four or more symptoms over a month or more.

The researchers found that women originally of normal weight who developed PTSD had a 36 percent higher risk of becoming overweight or obese, compared to women who, despite experiencing trauma, didn't develop PTSD.

This finding held even after taking into account other factors, such as depression, that have also been considered major factors in weight gain, the researchers said.

In women who had PTSD before the study period began, weight increased more rapidly than it did among women without PTSD.

Although the study found an association between women having PTSD and a higher risk for obesity, it did not establish a cause-and-effect.

"This important study highlights, once again, the significant impact that psychological disorders can have on physical health," said Simon Rego, director of psychology training at the Montefiore Medical Center and Albert Einstein College of Medicine, in New York City. He was not involved with the research.

Rego said trauma and obesity are both common in today's society. They can cause distress, difficulty in functioning and disability, he said, and all these conditions are hard to treat. That's why it's important for doctors to understand the impact of PTSD symptoms -- not only on mental health, but also on physical health.

Treating PTSD might also help in reversing weight gain, he said. "Doctors ... should be encouraged to screen for PTSD, especially in populations at high risk for trauma but also in patients presenting with obesity," he said.

If PTSD symptoms are found, the patient should be referred to a clinical psychologist or other mental-health professional with expertise in treating PTSD, Rego said.

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Phobias can be treated during sleep

A study claims that fears and phobias can be treated while people are sleeping.

Tallying sleep's benefits can seem as endless as counting sheep. Now, researchers say they might have found another benefit of sleep — it may be a good time to calm fears.

A fear was reduced in people by repeatedly exposing them to the fear memory during sleep, according to a study published online Sunday in the journal Nature Neuroscience.

"It's a novel finding," says Katherina Hauner, the study's lead author. "We showed a small but significant decrease in fear. The bigger picture is that, perhaps, the treatment of phobias can be enhanced during sleep." Hauner conducted the research when she was a postdoctoral fellow in neurology at the Northwestern University Feinberg School of Medicine in Chicago.

The study included 15 healthy young adults who received mild electric shocks while viewing two faces. They were exposed to an odor when seeing each face and getting a shock. In doing so, the face and odor were associated with fear. When a subject was sleeping, an odor was continuously presented but without the associated faces and shocks. When the subjects woke up, they were shown both faces. Their fear reactions were lower for the face linked to the odor they smelled during their rest.

There may be an advantage to adding a nighttime component to exposure therapy, a treatment for phobias and post-traumatic stress disorder, says Hauner, assistant director of the Cognitive Neuroscience Laboratory at the Rehabilitation Institute of Chicago.

Exposure therapy involves exposing a patient to a feared object or situation without danger to reduce anxiety. A therapist usually uses this technique with a patient during the day.

It may be helpful for patients if they can experience changes in their fear responses during sleep when they are not aware of the process, Hauner says. In that way, they wouldn't have to go through confronting the feared object or situation as much as they would in current therapy, she says.

"This is a new area of research," she adds. Further testing could look at whether the approach would produce long-term effects, she says. Also, the study examined memories created in a lab so further research could look at whether the approach would have an effect on pre-existing fear memories, she says.

"The study is important and exciting because it's a reminder that sleep doesn't just improve or consolidate memory," says Mark Mahowald, an American Academy of Neurology member who was not involved in the research. "It can extinguish memories."

"The extinction of memory during sleep could be important for people with PTSD and chemical dependencies," says Mahowald, a professor of neurology at the University of Minnesota Medical School in Minneapolis. "Further research could look at relapse prevention."

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Veterans with PTSD have less nightmares after sleep apnea treatment

A study shows that veterans who have PTSD have fewer nightmares after receiving sleep apnea treatment.

For military veterans suffering from post-traumatic stress disorder and sleep apnea, treatment with continuous positive airway pressure, or CPAP, reduces their nightmares, a new study finds.

Researchers reviewed the medical records of U.S. veterans who had been treated in a VA medical center sleep clinic between 2011 and 2012. The investigators looked at the average number of nightmares per week before treatment and up to six months after CPAP was prescribed for the veterans.

The use of CPAP led to a significant reduction in the number of nightmares, which was most connected to how well veterans complied with the treatment.

"Patients with PTSD get more motivated to use CPAP once they get restful sleep without frequent nightmares, and their compliance improves," principal investigator Dr. Sadeka Tamanna, medical director of the sleep disorders laboratory at G.V. (Sonny) VA Medical Center in Jackson, Miss., said in an American Academy of Sleep Medicine news release.

The findings were recently published online in the journal Sleep and presented at the annual meeting of the Associated Professional Sleep Societies, in Baltimore.

"One out of six veterans suffers from PTSD, which affects their personal, social and productive life," Tamanna said. "Nightmares are one of the major symptoms that affect their daily life, and prevalence of [sleep apnea] is also high among PTSD patients and can trigger their nightmares."

CPAP, which is a common treatment for sleep apnea, helps keep the airway open by providing a stream of air through a mask that is worn during sleep. PTSD symptoms such as nightmares usually start soon after a traumatic event but may not show up until months or years later, according to the National Center for PTSD of the U.S. Department of Veterans Affairs.

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Sleep helps lessen anxiety

A study shoes that people who are anxious are more likely to get inadequate sleep while those who sleep more tend to be less anxious.

Everyone knows what kind of effect a good night’s sleep can have on mood and new research from the University of California, Berkeley has shown that sleep deprivation can amplify activity in brain regions responsible foranxiety.

The researchers’ study, which was recently published in the Journal of Neuroscience, suggests that people who are naturally more anxious are more vulnerable to this effect of inadequate sleep.

“These findings help us realize that those people who are anxious by nature are the same people who will suffer the greatest harm from sleep deprivation,” said study co-author Matthew Walker, a professor of psychology and neuroscience at UC Berkeley.

The results also suggested that those suffering from generalized anxiety disorder, panic attacks and post-traumatic stress disorder may significantly benefit from sleep therapy. According to a press statement, other UC Berkeley scientists have been using sleep therapy on patients with depression, bipolar disorder and other mental conditions with encouraging results.

“If sleep disruption is a key factor in anxiety disorders, as this study suggests, then it’s a potentially treatable target,” Walker said. “By restoring good quality sleep in people suffering from anxiety, we may be able to help ameliorate their excessive worry and disabling fearful expectations.”

Previous studies have shown that sleep loss and mental disorders are frequently experienced together. The new study is the first make a causal link between sleep loss and anxiety-like brain activity, researchers said.

“It’s been hard to tease out whether sleep loss is simply a byproduct of anxiety, or whether sleep disruption causes anxiety,” said lead author Andrea Goldstein, a UC Berkeley doctoral student in neuroscience. “This study helps us understand that causal relationship more clearly.”

In their experiments, the UC Berkeley team captured brain images of 18 healthy volunteers as they viewed a series of neutral or disturbing images; once after a good night’s rest and again after a sleepless night.

While volunteers admitted to a wide range of baseline anxiety levels, none were determined to have a clinical anxiety disorder. After a full night’s rest at Berkeley’s sleep lab, participants’ brains were scanned using a functional MRI machine as they waited and then viewed 90 images during a 45-minute session.

Before showing the images, researchers primed the participants using three visual cues. A large red minus sign told participants that they were about to be shown a disturbing image, such as a death scene. A yellow circle told volunteers they were about to see a neutral image, such as a table. A white question mark, which could be followed by either a disturbing or innocuous image, was used to promote an anxious response from volunteers.

The research team found that anticipation during the white question mark caused anxiety-like activity in the emotional brain centers to soar for sleep-deprived participants, particularly in the amygdala and the insular cortex. This effect was most dramatic for those people who showed signs of being innately anxious.

“This discovery illustrates how important sleep is to our mental health,” said Walker. “It also emphasizes the intimate relationship between sleep and psychiatric disorders, both from a cause and a treatment perspective.”

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Up to 85% of US Military has Sleep Disorder

Research into the US Military shows that up to 85% of military personnel has some form of a sleep disorder.

Eighty-five percent of U.S. military study participants had a clinically relevant sleep disorder, researchers say.

Lead author Dr. Vincent Mysliwiec, chief of Pulmonary, Critical Care and Sleep Medicine at Madigan Army Medical Center in Tacoma, Wash., said 51 percent of had obstructive sleep apnea followed by 25 percent with insomnia.

The study involved an analysis of 725 diagnostic polysomnograms -- used to diagnose sleep problems -- performed in 2010 at Madigan Army Medical Center.

Study subjects were active duty military personnel from the U.S. Army, Air Force and Navy, comprising mostly men -- 93.2 percent -- and 85 percent were combat veterans. Sleep disorder diagnoses were adjudicated by a board certified sleep medicine physician.

The study, published in the journal Sleep, found the participants' mean self-reported home sleep duration was only 5.74 hours per night, and 41.8 percent reported sleeping 5 hours or less per night.

Individual sleep needs vary, but most adults need about 7 to 8 hours of nightly sleep to feel alert and well-rested during the day.

"While sleep deprivation is part of the military culture, the high prevalence of short sleep duration in military personnel with sleep disorders was surprising," Mysliwiec said in a statement. "The potential risk of increased accidents as well as long-term clinical consequences of both short sleep duration and a sleep disorder in our population is unknown." UPI

FACTS & FIGURES

Over 500,000 U.S. troops deployed to Afghanistan and Iraq since 2001 suffer from PTSD. All Voices

Every day about 22 veterans in the United States kill themselves, a rate that is about 20 percent higher than the Department of Veterans Affairs’ 2007 estimate, according to two-year study by a VA researcher. Washington Post

The U.S. military has been struggling to deal with the suicide crisis since numbers began rising in 2004. In 2012, the average was nearly one soldier suicide a day. NPR

The number of unemployed veterans rose above 800,000 in January, a spike that raises concerns about the long-term viability of efforts to find jobs for former military personnel. Stars and Stripes

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Study claims sleep deprivation lowers risk of post-traumatic stress disorder

If I was in colorado, I would advise modest sleep restriction for anyone traumatized by last weeks shooting. JR

A new study claims that a lack of sleep after a traumatic event reduces the risk of PTSD. This can help reduce the negative effects resulting from a traumatic event.

Sleep deprivation in the first few hours after exposure to a significantly stressful threat actually reduces the risk of Post-Traumatic Stress Disorder (PTSD), a new study has revealed.

The study revealed in a series of experiments that sleep deprivation of approximately six hours immediately after exposure to a traumatic event reduces the development of post trauma-like behavioural responses.

As a result, sleep deprivation the first hours after stress exposure might represent a simple, yet effective, intervention for PTSD.

Approximately 20 percent of people exposed to a severe traumatic event, such as a car or work accident, terrorist attack or war, cannot normally carry on their lives.

These people retain the memory of the event for many years. It causes considerable difficulties in the person’s functioning in daily life and, in extreme cases, may render the individual completely dysfunctional.

“Often those close to someone exposed to a traumatic event, including medical teams, seek to relieve the distress and assume that it would be best if they could rest and “sleep on it,” Prof. Prof. Hagit Cohen, director of the Anxiety and Stress Research Unit at BGU’s Faculty of Health Sciences, said.

“Since memory is a significant component in the development of post-traumatic symptoms, we decided to examine the various effects of sleep deprivation immediately after exposure to trauma,” Cohen said.

In the experiments, rats that underwent sleep deprivation after exposure to trauma, later did not exhibit behaviour indicating memory of the event, while a control group of rats that was allowed to sleep after the stress exposure did remember, as shown by their post trauma-like behaviour.

“As is the case for human populations exposed to severe stress, 15 to 20 percent of the animals develop long-term disruptions in their behaviour,” Cohen said.

“Our research method for this study is, we believe, a breakthrough in biomedical research,” Cohen added.

The new study was published in the international scientific journal, Neuropsychopharmacology

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The Stuff of Dreams: How Sleep Eases Emotional Trauma

Scientists have unlocked one of the great mysteries of the human experience, how we deal with traumatizing experiences that could leave us emotionally crippled. It happens during an "elegant ballet of biology" that softens painful memories, according to psychologist and neurologist Matthew Walker of the University of California, Berkeley, who led the research team.

And here's the amazing part: It all happens while we sleep. Our dreams help us heal.

"When you snooze you win," Walker said during a telephone interview.

Walker's team produced strong evidence that supports an assumption among scientists that a specific phase of sleep, called rapid eye movement, or REM, plays a key role in helping us deal with troubling emotions. Until now, there has been "little to no" evidence that's true, and there was even less understanding of how it works.

But the Berkeley team found that during REM, which is also the time we dream, stress chemicals are suppressed in the "emotional hub" of the brain called the amygdala. The research shows that after a good night's sleep, even potentially traumatizing experiences are softened.

"During REM sleep, memories are being reactivated, put in perspective and connected and integrated, but in a state where stress neurochemicals are beneficially suppressed," Els van der Helm, a doctoral student in psychology at Berkeley, said in releasing the study, published in the journal Current Biology.

About 20 to 25 percent of the time an adult spends sleeping is spent in REM, and scientists have suspected that REM plays a critical role in helping us deal with emotions because patients suffering with post traumatic stress disorder (PTSD) also suffer from sleep disorders, especially involving the REM phase.

"We've heard all our lives that if we are troubled, we should get to bed," Walker said. "We'll feel better tomorrow." But is that right?

The researchers put 35 "healthy young adults" through hours of lab-induced stress to see if there is any evidence that those old bromides are really true.

All of the participants spent two sessions inside a magnetic resonance imager, 12 hours apart. While their brains were being scanned for neurochemical activity, they were shown 150 images ranging from benign, like a friendly cat, to highly emotional, like a snake with fangs, or a burn victim.

The participants were divided into two groups. The members of one group had their first scan early in the day and their second 12 hours later, with no time to sleep between the sessions. The other group had one scan in the evening and the second the next morning, after sleeping in a controlled environment in the university's sleep lab.

As they viewed the images, all the participants "had a short period of time when they could rate the emotional intensity they were feeling in response to that individual image," Walker said. "That allowed us to get a subjective measure of how they themselves were feeling in response to those emotional images."

But the scanner also produced an objective measurement of the emotional reaction. In the first session, the amygdala literally "lit up" because of a strong reactivity by chemicals associated with stress. That was true for both groups.

The second session tells the story. The group that had no sleep experienced even stronger neurochemical reactivity when shown the images than they had during the first session. But the group that had a full night's sleep had relatively mild reactions to the images.

Read more: http://abcnews.go.com/Technology/dreams-ease-effects-trauma-post-traumatic-stress-disorder/story?id=15052034#.TtacY3M9a7g

Post-Traumatic Sleep Disorders

Although one may understand the prevalence of horrifying dreams in our returning soldiers, the specific sleep disorders falling upon them seem to be unique to their own combat experience.

A recent study shows that the specific traumatic experience a soldier faces causes the variety of sleep disorder he or she is fated for if that soldier has post-traumatic stress disorder (PTSD) or traumatic brain injury (TBI). Our nation's defenders find themselves overwhelmed by insomnia and sleep apnea, occurring in regards to their trigger.

Published in the journal Chest, this study oversaw 261 patients with either PTSD, TBI, or both. Even though the initial study was created to determine the prevalence of sleep disorders in these patients, in order to find specific correlations with these increased sleep disorder rates, clinical variables were incorporated and assessed.

The findings were as such:

• 71% showed sleep fragmentation (inability to sleep through the night)
• 87% showed hypersomnia (excessive sleepiness, usually during the day)

Further diagnostic sleep studies were performed on around 80% of patients:

• 56% diagnosed with obstructive sleep apnea (OSA)
• 49% diagnosed with insomnia

Now particularly interesting in regards to physical injury, those with blunt trauma had twice as much OSA while those with blast injuries experienced almost 25% more insomnia cases.

The study authors, doctors from the Walter Reed Army Medical Center in Washington, DC, warn that, "an increased awareness of the high prevalence of sleep disorders in combat veterans is critical given the chronicity of these disorders, and extension beyond the military healthcare system."

Read more: http://www.dailyrx.com/news-article/obstructive-sleep-apnea-insomnia-tbi-and-ptsd-16163.html