Abstract
Twenty-five veterans suffering from combat-related posttraumatic stress disorder were studied for 1–4 nights with all-night polysomnography. All subjects had sleep complaints. Analysis reveals that nineteen (76%) of the patients were found to have clinically significant periodic limb movements of sleep (PLMs) by the second night of study. PLMs are associated with sleep complaints in normals. For this reason the common assumption that sleep complaints in posttraumatic stress disorder are related only to the psychiatric disorder itself are challenged.
References
Akpinar, S. (1982). Treatment of restless legs syndrome with levodopa plus beserazide.Archives of Neurology, 29, 739.
Ancoli-Israel, S., Kripke, D. F., Mason, W., & Messin, S. (1981). Sleep apnea and nocturnal myoclonus in a senior population.Sleep, 4, 349–358.
Bixler, E. O., Kales, A., Vela-Bueno, A., Jacoby, J. A., Scarone, S., & Soldatos, C. R. (1982). Nocturnal myoclonus and nocturnal myoclonic activity in the normal population.Research in Communication Chemical Pathology and Pharmacology, 36, 129–140.
Blake, D. D., Weathers, F., Negy, L. M., Kaloupek, D. G., Klauminzer, G., Charney, D. S., & Keane, T. M. (1993). A clinician rating scale for assessing current and lifetime PTSD: CAPS-1.The Behavior Therapist, 18, 187–188.
Bliwise, D. L., Carskadon, M. A., & Dement, W. C. (1988). Nightly variation of periodic leg movements in sleep in middle aged and elderly individuals.Archives of Gerontology and Geriatrics, 7, 273–279.
Boudewyns, P. A., Albrecht, J. W., Talbert, F. S., & Hyer, L. A. (1991). Comorbidity and treatment outcome of inpatients with chronic combat-related PTSD.Hospital and Community Psychiatry, 42, 847–849.
Boudewyns, P. A., Stwerka, S. A., Hyer, L. A., Albrecht, J. W., & Sperr, E. V. (1993). Eye movement desensitization for PTSD of combat: A treatment outcome pilot study.The Behavior Therapist, 16, 29–33.
Boudewyns, P. A., Woods, M. G., Hyer, L., & Albrecht, J. W. (1992). Chronic combat-related PTSD and concurrent substance abuse: Implications for treatment of this frequent “dual diagnosis.”Journal of Traumatic Stress, 4, 549–650.
Brophy, M. H. (1991). Cyproheptadine for combat nightmares in post-traumatic stress disorder and dream anxiety disorder.Military Medicine, 156, 100–101.
Carskadon, M. & Rechtshaffen, A. (1989). Monitoring and staging human sleep. In M. H. Kryger, T. Roth & W. C. Dement (Eds.),Principles and practice of sleep medicine (pp. 680–681). Philadelphia: Saunders.
Coleman, R. M., Pollak, C. P., & Weitzman, E. D. (1980). Periodic movements in sleep (nocturnal myoclonus): Relation to sleep disorders.Annals of Neurology, 8, 416–421.
Dagan, Y., Lavie, P., & Bleich, A. (1991). Elevated awakening thresholds in sleep stage 3–4 in war-related post-traumatic stress disorder.Biological Psychiatry, 30, 618–622.
Greenberg, R., Pearlman, C. A., & Gampel, D. (1972). War neuroses and the adaptive function of REM sleep.British Journal of Medical Psychology, 45, 27–33.
Guilleminault, C. (1989). Clinical features and evaluation of obstructive sleep apnea syndrome. In M. H. Kryger, T. Roth, & W. C. Dement (Eds),Principles and practice of sleep medicine (pp. 553–555). Philadelphia: Saunders.
Gurvits, T. V., Lasko, N. B., Schachter, S. C., Kuhne, A. A., Orr, S. P., & Pitman, R. K. (1993). Neurological status of Vietnam veterans with chronic posttraumatic stress disorder.Journal of Neuropsychiatry Clinical Neuroscience, 5, 183–188.
Hartmann, E. (1984).The nightmare: The psychology and biology of terrifying dreams. New York: Basic Books.
Hudson, J. I., Manoach, D. S., Sabo, A. N., & Sternbach, S. E. (1991). Recurrent nightmares in posttraumatic stress disorder: Association with sleep paralysis, hypnopompic hallucinations, and REM sleep.Journal of Nervous and Mental Disease, 179, 572–573.
Kauffman, C. D., Reist, C., & Djenderejian, A. (1987). Biological markers of affective disorders and posttraumatic stress disorder.Journal of Clinical Psychiatry, 48, 366–367.
Kravitz, M., McCoy, B. J., Tompkins, D. M., Daly, W., Mulligan, J., McCauley, R. L., Robson, M.C., & Herndon, D. N. (1993). Sleep disorders in children after burn injury.Journal of Burn Care and Rehabilitation, 14, 58–64.
Lavie, P., Hefez, A., Halperin, G. H. A., & Enoch, D. (1979). Long-term effects of traumatic war-related events on sleep.American Journal of Psychiatry, 136, 175–178.
Lugaresi, E., Cirignotta, F., Coccagna, G., & Montagna, P. (1986). Nocturnal myoclonus and restless legs syndrome.Advances in Neurology, 43, 295–307.
Lyles, J., van Egeren, L., Shaffer, D., & Hulce, V. (1992). Periodic limb movement disorder is associated with normal motor conduction latencies when studied by central magnetic stimulation.Sleep, 15, 312–318.
Oshtory, M. A., & Vijayan, N. (1980). Clonazepam treatment of insomnia due to sleep myoclonus.Archives of Neurology, 37, 119–120.
Rechtschaffen, A., & Kales, A. (1968).A manual of standardized terminology: Techniques and scoring system for sleep stages of human subjects. Los Angeles: UCLA Brain Information Service/Brain Research Institute.
Schenck, C. H. & Mahowald, M. W. (1990). Polysomnographic, neurologic, psychiatric, and clinical outcome report on 70 consecutive cases with REM sleep behavior disorder.Cleveland Clinic Journal of Medicine, 57, S9-S23.
Schlosberg, A. & Benjamin, M. (1978). Sleep patterns in three acute combat fatigue cases.Journal of Clinical Psychiatry, 39, 546–549.
Shapiro, F. (1989). Eye movement desensitization: A new treatment for post-traumatic stress disorder.Journal of Behavior Therapy and Experimental Psychiatry, 20, 211–217.
Smith, R. C. (1987). Confirmation of Babinski-like response in periodic movements in sleep (nocturnal myoclonus).Biological Psychiatry, 22, 1271–1273.
Smith, R. C., Gouin, P. R., & Minkley, P. (1992). Periodic limb movement disorder is associated with normal motor conduction latencies when studied by central magnetic stimulation-successful use of a new technique.Sleep, 15, 312–318.
Spitzer, R. L., Williams, Janet B. W., Gibbon, M., & First, M. B. (1990).Structured Clinical Interview for DSM-III-R Patient Edition (SCID-P, version 1.0), Washington, DC: American Psychiatric Press.
Thorpy, M. (Ed). (1990).International classification of sleep disorders: Diagnostic and coding manual, Rochester, Minnesota: American Sleep Disorders Association.
van Kammen, W. B., Christiansen, C., & van Kammen, D. P. (1987). Sleep and the POW experience.Sleep Research, 16, 291.
van Kammen, W. B., Christiansen, C., van Kammen, D. P., and Reynolds, III C. F. (1990). Sleep and the prisoner-of-war experience-40 years later. In E. L. Giller (Ed.),Biological assessment and treatment of posttraumatic stress disorder (pp. 161–172). Washington, DC: American Psychiatric Press, Inc.
van der Kolk, B., Blitz, R., Burr, W., Sherry, S., and Hartmann, E. (1984). Nightmares and trauma: A comparison of nightmares after combat with lifelong nightmares in veterans.American Journal of Psychiatry, 141, 187–190.
Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., & Badr, S. (1993). The occurrence of sleep disordered breathing among middle-aged adults.New England Journal of Medicine, 29, 328, 1230–1235.
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Brown, T.M., Boudewyns, P.A. Periodic limb movements of sleep in combat veterans with posttraumatic stress disorder. J Trauma Stress 9, 129–136 (1996). https://doi.org/10.1007/BF02116838
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DOI: https://doi.org/10.1007/BF02116838