Sleep and depression in combat-related PTSD inpatients

The sleep of 27 unmedicated Vietnam combat-related posttraumatic stress disorder (PTSD) inpatients was monitored for 3 nights. Depressive comorbidity was considered both as a diagnostic category using DMS-III-R criteria, and as a continuous variable using the Beck Depression Inventory (BDI). Data co...

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Bibliographic Details
Published in:Biological psychiatry (1969) 1996-02, Vol.39 (3), p.182-192
Main Authors: Woodward, Steven H., Friedman, Matthew J., Bliwise, Donald L.
Format: Article
Language:English
Subjects:
Adult
Combat Disorders - diagnosis
Combat Disorders - psychology
Comorbidity
depression
Depressive Disorder - diagnosis
Depressive Disorder - psychology
Electromyography
EMG
Humans
Male
Middle Aged
Polysomnography
Psychiatric Status Rating Scales
Reaction Time
Sleep
Sleep Wake Disorders - diagnosis
Sleep Wake Disorders - psychology
Sleep, REM
stress
trauma
Veterans - psychology
Vietnam
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Summary:The sleep of 27 unmedicated Vietnam combat-related posttraumatic stress disorder (PTSD) inpatients was monitored for 3 nights. Depressive comorbidity was considered both as a diagnostic category using DMS-III-R criteria, and as a continuous variable using the Beck Depression Inventory (BDI). Data collected included sleep architecture features that have discriminated unipolar depressives from controls in many prior studies, rapid eye movement (REM) sleep latency, and slow-wave sleep time, as well as two additional indices that have sometimes discriminated depressives from controls in waking studies—baseline heart rate and facial electromyography. Structured Clinical Interview for the DSM-III-R (SCID)-diagnosed PTSD + major depressive disorder (MDD) patients failed to exhibit shorter REM latencies, greater REM percents of sleep, or greater REM densities than PTSD − MDD patients, but did exhibit less slow wave sleep. PTSD + MDD patients also exhibited less facial (mentalis) electromyographic activity. REM densities and baseline heart rates were equivocal. REM density, baseline heart rate, and mentalis electromyography all correlated with the BDI, the former two positively, the last, negatively. In summary, SCID-diagnosed PTSD + MDD patients failed to exhibit the classic REM sleep architectural modifications associated with unipolar depression, despite the fact that several other psychophysiologic indices of dysphoria were detectable in their sleep.
ISSN:0006-3223
1873-2402
DOI:10.1016/0006-3223(95)00104-2