Sleep disturbances, TBI and PTSD: Implications for treatment and recovery

Post-Traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), and sleep problems significantly affect recovery and functional status in military personnel and Veterans returning from combat. Despite recent attention, sleep is understudied in the Veteran population. Few treatments and rehabili...

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Veröffentlicht in:Clinical psychology review Jg. 40; S. 195 - 212
Hauptverfasser: Gilbert, Karina Stavitsky, Kark, Sarah M., Gehrman, Philip, Bogdanova, Yelena
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Ltd 01.08.2015
Schlagworte:
Actigraphy
Brain Injuries - epidemiology
Brain Injuries - physiopathology
Brain Injuries - therapy
Cognition
Comorbidity
Humans
Interventions
Neuromodulation
Paradoxical insomnia
PTSD
Sleep
Sleep physiology
Sleep Wake Disorders - epidemiology
Sleep Wake Disorders - physiopathology
Sleep Wake Disorders - therapy
Stress Disorders, Post-Traumatic - epidemiology
Stress Disorders, Post-Traumatic - physiopathology
Stress Disorders, Post-Traumatic - therapy
TBI
Veterans
Veterans - psychology
MNPO
Veterans
ACTH
NREM
Paradoxical insomnia
HPA axis
IRT
Cognition
Neuromodulation
CSF
Sleep physiology
TBI
OSA
SWA
VLPO
CBT-I
CRSD
BDNF
PSG
Actigraphy
LED
LLLT
SWS
PTSD
Sleep
Interventions
SWDs
TST
CAR
OEF/OIF/OND
REM
mTBI
ISSN:0272-7358, 1873-7811, 1873-7811
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Zusammenfassung:Post-Traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), and sleep problems significantly affect recovery and functional status in military personnel and Veterans returning from combat. Despite recent attention, sleep is understudied in the Veteran population. Few treatments and rehabilitation protocols target sleep, although poor sleep remains at clinical levels and continues to adversely impact functioning even after the resolution of PTSD or mild TBI symptoms. Recent developments in non-pharmacologic sleep treatments have proven efficacious as stand-alone interventions and have potential to improve treatment outcomes by augmenting traditional behavioral and cognitive therapies. This review discusses the extensive scope of work in the area of sleep as it relates to TBI and PTSD, including pathophysiology and neurobiology of sleep; existing and emerging treatment options; as well as methodological issues in sleep measurements for TBI and PTSD. Understanding sleep problems and their role in the development and maintenance of PTSD and TBI symptoms may lead to improvement in overall treatment outcomes while offering a non-stigmatizing entry in mental health services and make current treatments more comprehensive by helping to address a broader spectrum of difficulties. •Poor sleep may impact recovery and treatment outcome in Veterans with PTSD and TBI.•Sleep difficulties are a risk factor for the development and maintenance of PTSD.•TBI patients can suffer permanent sleep problems regardless of injury severity.•Sleep-focused interventions could augment current TBI and PTSD treatment protocols.•We review physiological mechanisms and treatment of sleep problems in TBI and PTSD.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
ObjectType-Review-3
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Co-first authors contributed equally to the manuscript.
ISSN:0272-7358
1873-7811
1873-7811
DOI:10.1016/j.cpr.2015.05.008