EXCEED THE SPACE PROVIDED. The persistence and morbidity associated with established PTSD has increased interest in understanding early pathogenesis. While initial reactions appear to have a role in determining the subsequent course of PTSD there is also evidence for critical processes during the initial months following trauma exposure that lead to the consolidation or resolution of PTSD symptoms.
The aim of the previous study has been to elucidate factors contributing to the early development of PTSD following traumatic injury with an emphasis on the role of sleep. Findings include a strong association of dreams with content that is similar to the recent trauma and more severe PTSD symptoms. Polysomnography findings reveal that patterns of REM versus non-REM sleep disruption (wake entries) distinguishthe subjects who are developing versus not developing PTSD. These data suggest that activation of relatively unaltered trauma memories during sleep and intrusion of wake into REM, contribute to the consolidation of PTSD, possibly by interfering with a potentially adaptive memory processing function of REM sleep. The present study aims to more fully establish this hypothesis and extend the investigation to underlying mechanisms. In addition to the more traditional measures of REM sleep maintenance and other sleep measures, sleep EEG data will be subjected to analyses of spectral power to reflect arousal patterns during REM and other sleep stages, and wave-let analysis to examine patterns of micro-discontinuity.Heart ratevariability during sleep will also be evaluated in order to evaluate relationshipsof relative sympathetic activation and disruption of REM sleep and development of PTSD. Finally, we are developing a procedure for evaluating memory functions relevant to the role of REM sleep and the development of PTSD. Priming for the latency to recognition of faded in stimuli that are trauma and non-trauma related will be evaluated across the sleep period and related to subsequent PTSD status and characteristics of intervening sleep. Recently traumatized subjects will be recruited from the Dartmouth-Hitchcock Medical Center (DHMC) and University of Miami Trauma Services, and will be longitudinally assessed over a six month period. =ERFORMANCE SITE(S) (organization, city, state) Dartmouth Hitchcock Medical Center, Lebanon,Ntr^nd thf University of Miami, Jackson Memorial J Center, Miami. FL __^ KEY PERSONNEL ========================================Section End===========================================
| Kobayashi, Ihori; Mellman, Thomas A (2012) Gender differences in sleep during the aftermath of trauma and the development of posttraumatic stress disorder. Behav Sleep Med 10:180-90 |
| 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 |
