PTSD sleep research thinks new way

Wish Fulfillment? No. But Dreams (and Sleep) Have Meaning
By Tiffany Sharples Sunday, Jun. 14, 2009
Dreams may not be the secret window into the frustrated desires of the unconscious that Sigmund Freud first posited in 1899, but growing evidence suggests that dreams —and, more so, sleep — are powerfully connected to the processing of human emotion.



According to new research presented last week at the annual meeting of the Associated Professional Sleep Societies in Seattle, adequate sleep may underpin our ability to understand complex emotions properly in waking life.

Past studies have also established a link between chronic sleep disruption and suicide. Sleep complaints, which include nightmares, insomnia and other sleep disturbances, are listed in the current Substance Abuse and Mental Health Services Administration's inventory of suicide prevention warning signs. Yet, what distinguishes Bernert's research is that when nightmares and insomnia were evaluated separately, nightmares were still independently predictive of suicidal behavior. "It may be that nightmares present a unique risk for suicidal symptoms, which may have to do with the way we process emotion within dreams," Bernert says.

If that's the case, it may help explain the recurring nightmares that characterize psychiatric conditions such as post-traumatic stress disorder (PTSD), Walker says.

"The brain has not stripped away the emotional rind from that experience memory," he says, so "the next night the brain offers this up, and it fails again, and it starts to sound like a broken record...What you hear [PTSD] patients describing is, 'I can't get over the event.'"

At the biological level, Walker explains, the "emotional rind" translates to sympathetic nervous system activity during sleep — faster heart rate and the release of stress chemicals. Understanding why nightmares recur and how REM sleep facilitates emotional processing, or hinders it when nightmares take place and perpetuate the physical stress symptoms, may eventually provide clues for effective treatments of painful mental disorders. Perhaps, even, by simply addressing sleeping habits, doctors could potentially interrupt the emotional cycle that can lead to suicide. "There is an opportunity for prevention," Bernert says.

The new findings highlight what researchers are increasingly recognizing as a two-way relationship between psychiatric disorders and disrupted sleep. "Modern medicine and psychiatry have consistently thought that psychological disorders seem to have co-occuring sleep problems, and that it's the disorder perpetuating the sleep problems," says Walker. "Is it possible that, in fact, it's the sleep disruption contributing to the psychiatric disorder?"

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http://www.time.com/time/health/article/0,8599,1904561,00.html