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Sleep. 2018 Aug 29. doi: 10.1093/sleep/zsy174. [Epub ahead of print]

Posttraumatic Stress Disorder Diagnosis is Associated with Reduced Parasympathetic Activity during Sleep in United States Veterans and Military Service Members of the Iraq and Afghanistan Wars.

Author information

1
Durham VA Health Services Research & Development.
2
Duke University Department of Psychiatry and Brain Sciences.
3
University of Pittsburgh, Department of Psychiatry.
4
Durham VA Research & Development.

Abstract

Study Objectives:

To determine whether high frequency heart rate variability (HF-HRV) during sleep differs between those with and without PTSD as a function of sleep type (NREM versus REM), and to explore this relationship across successive sleep cycles. Participants with PTSD were hypothesized to have lower HF-HRV across both REM and NREM sleep.

Methods:

Sixty-two post-9/11 military veterans and service members completed self-report measures of sleep quality, insomnia severity, and disruptive nocturnal behaviors. Participants then completed a laboratory-based polysomnographic study night with concurrent HRV assessment.

Results:

Participants with PTSD (N=29) had lower HF-HRV in overall NREM sleep relative to those without PTSD (N=33) [F(1, 54) = 4.24, p = .04]. Groups did not differ on overall HF-HRV during REM sleep. HF-HRV increased over the night for the sample as a whole during both NREM and REM sleep. PTSD status did not moderate the association between HF-HRV and sleep cycles. However, the PTSD group had lower HF-HRV in the first t(155) = 2.67, p = .008, and fourth NREM cycles, t(155) = 2.11, p = .036, relative to participants without PTSD.

Conclusions:

Findings suggest blunted parasympathetic modulation during NREM sleep in a young cohort of military veterans and service-members with PTSD. Findings are concerning considering the increased risk of incident cardiovascular events associated with impaired parasympathetic nervous system function. Reduced parasympathetic modulation may be one mechanism underlying the increased prevalence of CVD among Veterans with PTSD.

PMID:
30169878
DOI:
10.1093/sleep/zsy174

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