![]() "It was unknown at that time what diagnosis they had."īy having TSD officially recognized as a distinct, novel parasomnia, "we are hoping to encourage future research into the disorder as well as treatment-related studies," said Mysliwiec, noting that would best be accomplished by larger studies at both military and veteran health care facilities.Īdditional research also would be beneficial for people with non-combat-related trauma. "We evaluated many service members who had these symptoms but did not meet diagnostic criteria for either REM sleep behavior disorder or PTSD," he added. "This was when we initially saw active-duty service members who presented with trauma-related nightmares, dream enactment behaviors, and rapid breathing, night sweats and racing heart rates shortly after returning from combat," Mysliwiec said. (Dr.) Vincent Mysliwiec, director of sleep medicine, UT Health San Antonio, and co-author on the study, has been researching this phenomenon since 2003, when he was assigned to Madigan Army Medical Center and during the peak of Operations Iraqi and Enduring Freedom. However, PTSD includes daytime and nocturnal symptoms, while many TSD patients only experience nocturnal symptoms.Īdditionally, nightmare disorders typically don't include dream enactment or repeating nightmares about a trauma experience, Brock explained.Īlthough it had not been given a name, TSD symptoms have been studied for many years. However, TSD also includes vivid, repeating nightmares about the individua's trauma and symptoms of autonomic hyperarousal, which is when the fight or flight response kicks in and one's heart rate or respiratory rate accelerates during sleep.ĭistinguishing TSD from Other Sleep DisordersĪ key focus of the study is to distinguish TSD from other diagnoses, such as RBD, post-traumatic stress disorder and nightmare disorder, Brock said.įor example, TSD symptoms are often associated with PTSD. TSD is similar to RBD regarding dream enactment. "This is disruptive, and often scary, not only for the patient, but for his or her bed partner as well." "Dream enactment behavior can include punching, kicking, defensive posturing, yelling, and movements," Brock said. ![]() This is called RBD and is commonly seen in people with neurodegenerative disorders such as Parkinson's disease, Brock explained. However, in some cases, the part of the brainstem responsible for paralyzing the skeletal muscle degenerates, which may result in dream enactment. Typically, during REM sleep, the skeletal muscle, other than eyes, diaphragm and sphincter muscles, is paralyzed to prevent people from acting out dreams. This is groundbreaking because traditional wisdom is that parasomnia behavior is almost never captured in the sleep lab but is frequently cited by patients as a symptom they're experiencing at home." "Our key finding was that most of these patients had parasomnia behavior, or movements and vocalizations in REM sleep. "We watched all eight hours of video on each sleep study, which is not typical," Brock said, noting that many sleep centers record eight hours but rarely watch the video recording in its entirety. The study comprised a clinical interview and video-recorded sleep study. That is when someone acts out dreams physically or verbally. ![]() ![]() The study, which spanned five years, included 40 service members who had experienced trauma, mainly from combat, and were experiencing dream enactment. "We believe trauma-associated sleep disorder is the first adult sleep disorder and rapid eye movement (REM) parasomnia identified since Rapid Eye Movement Sleep Behavior Disorder (RBD) was identified more than 35 years ago," he said. Air Force Lt Col (Dr.) Matthew Brock, the study's lead author and chief of the San Antonio Market Sleep Disorders Center at Wilford Hall Ambulatory Surgical Center at Joint Base San Antonio-Lackland, Texas. While there have been related studies, this was the largest to date and identifies trauma associated sleep disorder, or TSD, as a distinct sleep-related disorder or parasomnia, explained U.S. The Journal of Clinical Sleep Medicine published the groundbreaking study, titled "Clinical and polysomnographic features of trauma associated sleep disorder" on its site in August. Traumatic Brain Injury Center of Excellence | MHS Mental Health HubĪ team of military and civilian researchers has identified a new sleep disorder that's been disrupting the lives of trauma survivors for decades, if not centuries.
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