Post-traumatic Stress Disorder or PTSD is a common sequela of life threatening stressors and is associated with significant chronicity and psychosocial morbidity. Severe accidents are common life threatening events yet PTSD related to accidental injury remains under-investigated. Sleep disturbance is an integral feature of PTSD and may have a role in the development and maintenance of the disorder. We propose to study PTSD symptoms and their relationship to sleep phenomena during an acute phase following severe accidental injury. Patients hospitalized for life threatening accidents at a regional Trauma Center will be screened, and if appropriate, PTSD and other psychiatric and medical parameters will be evaluated. Patients' sleep will then be recorded with a portable polysomnographic unit. Associations of sleep measures with PTSD symptom severity will be determined. Attempts will have been made to reduce the impact of medical/surgical factors on sleep through screening procedures. Possible relationships of these factors, as well as that of other psychiatric variables to sleep measures, will be explored in analyses.
The final aim of the study is to evaluate the relationship of sleep consolidation and PTSD symptom reduction. Symptomatic patients will be randomly assigned to a 7 day course of hypnotic medication versus placebo while receiving clinical management, during a 2 week treatment phase. Sleep, PTSD, and mood symptoms will be assessed prior to initiating and at the completion of the treatment phase. The final study evaluation for symptom severity and functional adjustment will occur 1 month later (6 weeks from baseline assessments) for all of the original subjects.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH054006-03
Application #
2675324
Study Section
Violence and Traumatic Stress Review Committee (VTS)
Project Start
1996-09-01
Project End
2000-04-30
Budget Start
1998-05-01
Budget End
1999-04-30
Support Year
3
Fiscal Year
1998
Total Cost
Indirect Cost
Name
University of Miami School of Medicine
Department
Psychiatry
Type
Schools of Medicine
DUNS #
City
Miami
State
FL
Country
United States
Zip Code
33146
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Mellman, Thomas A; Pigeon, Wilfred R; Nowell, Peter D et al. (2007) Relationships between REM sleep findings and PTSD symptoms during the early aftermath of trauma. J Trauma Stress 20:893-901
Mellman, Thomas A; Knorr, Bethany R; Pigeon, Wilfred R et al. (2004) Heart rate variability during sleep and the early development of posttraumatic stress disorder. Biol Psychiatry 55:953-6
Mellman, Thomas A; Bustamante, Victoria; David, Daniella et al. (2002) Hypnotic medication in the aftermath of trauma. J Clin Psychiatry 63:1183-4
Mellman, Thomas A; Bustamante, Victoria; Fins, Ana I et al. (2002) REM sleep and the early development of posttraumatic stress disorder. Am J Psychiatry 159:1696-701
Mellman, T A; David, D; Bustamante, V et al. (2001) Predictors of post-traumatic stress disorder following severe injury. Depress Anxiety 14:226-31
Bustamante, V; Mellman, T A; David, D et al. (2001) Cognitive functioning and the early development of PTSD. J Trauma Stress 14:791-7