Abstract Details

Title Abnormal REM Sleep Atonia Control in Patients With Chronic Post-Traumatic Stress Disorder

Topic Sleep

Presentation(s) S3 - Sleep Medicine: Highlights 2020 (2:36 PM-2:48 PM)

Poster/Presentation
Number 009

Objective We aimed to comparatively analyze REM sleep without atonia levels between patients with chronic Post-traumatic stress disorder (PTSD) with and without REM Sleep Behavior Disorder (RBD), idiopathic RBD (iRBD), and controls.

Background PTSD is characterized by persistent mental and emotional stress following physically or psychologically traumatic events. Vivid recall of events, including traumatic nightmares, and prominent sleep disturbances are frequent in PTSD. Previous studies suggest military combat associated PTSD and psychiatric illness may share clinical features, such as altered REM sleep without atonia (RSWA), with idiopathic REM sleep behavior disorder (iRBD).

Design/Methods We selected 18 PTSD, 18 PTSD+RBD, 15 iRBD, and 51 healthy control patients matched for age and sex from the Mayo Clinic Center for Sleep Medicine’s polysomnography database for RSWA quantification. RSWA amounts in the submentalis (SM) and anterior tibialis (AT) were quantitatively analyzed in accordance with previously published methods. Non-parametric analyses were performed to compare RSWA, patient demographics, and PSG data.

Results

Patients with PTSD had significantly higher RSWA than controls in all RSWA density measures (p < 0.016 for all). All measures of RSWA, excluding average SM duration, were significantly higher in PTSD+RBD patients compared with controls (p < 0.016 for all). PTSD+RBD patients had significantly higher SM Phasic, AT Any, SM+AT Any, and Tonic RSWA measures than PTSD patients (p <0.016 for all).

Conclusions

PTSD patients have significantly higher RSWA than controls, with PTSD+RBD patients having higher RSWA levels than PTSD patients. These data provide the first evidence for abnormal RSWA control in patients with chronic PTSD. This provides evidence for a unique biology in PTSD that could imply a future risk for neurodegenerative disease in PTSD similar to RBD patients. Further prospective studies will need to be performed on patients with PTSD to further understand this risk.

Authors/Disclosures
John C. Feemster, MD (Johns Hopkins Hospital) PRESENTER	Mr. Feemster has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Thomas Gossard, MD	Mr. Gossard has nothing to disclose.
	No disclosure on file
	No disclosure on file
Stuart J. McCarter, MD (Mayo Clinic)	The institution of Dr. McCarter has received research support from NIH. The institution of Dr. McCarter has received research support from American Academy of Sleep Medicine Foundation.
Erik K. St. Louis, MD (Mayo Clinic)	The institution of Dr. St. Louis has received research support from NIH. Dr. St. Louis has received publishing royalties from a publication relating to health care. Dr. St. Louis has received publishing royalties from a publication relating to health care.

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