Trauma associated sleep disorder: a proposed parasomnia encompassing disruptive nocturnal behaviors, nightmares, and REM without atonia in trauma survivors. 2014

Vincent Mysliwiec, and Brian O'Reilly, and Jason Polchinski, and Herbert P Kwon, and Anne Germain, and Bernard J Roth
Brian Allgood Army Community Hospital, South Korea.

OBJECTIVE To characterize the clinical, polysomnographic and treatment responses of patients with disruptive nocturnal behaviors (DNB) and nightmares following traumatic experiences. METHODS A case series of four young male, active duty U.S. Army Soldiers who presented with DNB and trauma related nightmares. Patients underwent a clinical evaluation in a sleep medicine clinic, attended overnight polysomnogram (PSG) and received treatment. We report pertinent clinical and PSG findings from our patients and review prior literature on sleep disturbances in trauma survivors. RESULTS DNB ranged from vocalizations, somnambulism to combative behaviors that injured bed partners. Nightmares were replays of the patient's traumatic experiences. All patients had REM without atonia during polysomnography; one patient had DNB and a nightmare captured during REM sleep. Prazosin improved DNB and nightmares in all patients. CONCLUSIONS We propose Trauma associated Sleep Disorder (TSD) as a unique sleep disorder encompassing the clinical features, PSG findings, and treatment responses of patients with DNB, nightmares, and REM without atonia after trauma.

UI MeSH Term Description Entries
D008297 Male Males
D008889 Military Personnel Persons including soldiers involved with the armed forces. Air Force Personnel,Armed Forces Personnel,Army Personnel,Coast Guard,Marines,Navy Personnel,Sailors,Soldiers,Submariners,Military,Force Personnel, Air,Personnel, Air Force,Personnel, Armed Forces,Personnel, Army,Personnel, Military,Personnel, Navy,Sailor,Soldier,Submariner
D009129 Muscle Tonus The state of activity or tension of a muscle beyond that related to its physical properties, that is, its active resistance to stretch. In skeletal muscle, tonus is dependent upon efferent innervation. (Stedman, 25th ed) Muscle Tension,Muscle Tightness,Muscular Tension,Tension, Muscle,Tension, Muscular,Tightness, Muscle,Tonus, Muscle
D011224 Prazosin A selective adrenergic alpha-1 antagonist used in the treatment of HEART FAILURE; HYPERTENSION; PHEOCHROMOCYTOMA; RAYNAUD DISEASE; PROSTATIC HYPERTROPHY; and URINARY RETENTION. Furazosin,Minipress,Pratsiol,Prazosin HCL,Prazosin Hydrochloride,HCL, Prazosin,Hydrochloride, Prazosin
D004325 Dreams A series of thoughts, images, or emotions occurring during sleep which are dissociated from the usual stream of consciousness of the waking state. Nightmares,Dream,Nightmare
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001523 Mental Disorders Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. Mental Illness,Psychiatric Diseases,Psychiatric Disorders,Psychiatric Illness,Behavior Disorders,Diagnosis, Psychiatric,Mental Disorders, Severe,Psychiatric Diagnosis,Illness, Mental,Mental Disorder,Mental Disorder, Severe,Mental Illnesses,Psychiatric Disease,Psychiatric Disorder,Psychiatric Illnesses,Severe Mental Disorder,Severe Mental Disorders
D012893 Sleep Wake Disorders Abnormal sleep-wake schedule or pattern associated with the CIRCADIAN RHYTHM which affect the length, timing, and/or rigidity of the sleep-wake cycle relative to the day-night cycle. Sleep Disorders,Long Sleeper Syndrome,Short Sleep Phenotype,Short Sleeper Syndrome,Sleep-Related Neurogenic Tachypnea,Subwakefullness Syndrome,Disorder, Sleep,Disorder, Sleep Wake,Disorders, Sleep,Disorders, Sleep Wake,Long Sleeper Syndromes,Neurogenic Tachypnea, Sleep-Related,Neurogenic Tachypneas, Sleep-Related,Phenotype, Short Sleep,Phenotypes, Short Sleep,Short Sleep Phenotypes,Short Sleeper Syndromes,Sleep Disorder,Sleep Phenotypes, Short,Sleep Related Neurogenic Tachypnea,Sleep Wake Disorder,Sleep-Related Neurogenic Tachypneas,Sleeper Syndrome, Long,Sleeper Syndrome, Short,Sleeper Syndromes, Long,Sleeper Syndromes, Short,Subwakefullness Syndromes,Syndrome, Long Sleeper,Syndrome, Short Sleeper,Syndrome, Subwakefullness,Syndromes, Long Sleeper,Syndromes, Short Sleeper,Syndromes, Subwakefullness,Tachypnea, Sleep-Related Neurogenic,Tachypneas, Sleep-Related Neurogenic,Wake Disorder, Sleep,Wake Disorders, Sleep
D012895 Sleep, REM A stage of sleep characterized by rapid movements of the eye and low voltage fast pattern EEG. It is usually associated with dreaming. Fast-Wave Sleep,Paradoxical Sleep,Rapid Eye Movements,Rhombencephalic Sleep,Sleep, Fast-Wave,REM Sleep,Eye Movement, Rapid,Eye Movements, Rapid,Fast Wave Sleep,Movement, Rapid Eye,Movements, Rapid Eye,Rapid Eye Movement,Sleep, Fast Wave,Sleep, Paradoxical,Sleep, Rhombencephalic

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