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Sleep. 2019 Sep 25. pii: zsz207. doi: 10.1093/sleep/zsz207. [Epub ahead of print]

An Attempt to Identify Reproducible High-Density EEG Markers of PTSD during Sleep.

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Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Materiel Command, USA.
The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., USA.
Department of Psychiatry, University of Pittsburgh School of Medicine, USA.



We examined electroencephalogram (EEG) spectral power to study abnormalities in regional brain activity in post-traumatic stress disorder (PTSD) during sleep. We aimed to identify sleep EEG markers of PTSD that were reproducible across nights and subsamples of our study population.


Seventy-eight combat-exposed veteran men with (n = 31) and without (n = 47) PTSD completed two consecutive nights of high-density EEG recordings in a laboratory. We performed spectral-topographical EEG analyses on data from both nights. To assess reproducibility, we used the first 47 consecutive participants (18 with PTSD) for initial discovery and the remaining 31 participants (13 with PTSD) for replication.


In the discovery analysis, compared to non-PTSD participants, PTSD participants exhibited 1) reduced delta power (1-4 Hz) in the centro-parietal regions during non-rapid-eye-movement (NREM) sleep and 2) elevated high-frequency power, most prominent in the gamma band (30-40 Hz), in the antero-frontal regions during both NREM and rapid-eye-movement (REM) sleep. These findings were consistent across the two study nights, with reproducible trends in the replication analysis. We found no significant group differences in theta power (4-8 Hz) during REM sleep and sigma power (12-15 Hz) during N2 sleep.


The reduced centro-parietal NREM delta power, indicating reduced sleep depth, and the elevated antero-frontal NREM and REM gamma powers, indicating heightened central arousal, are potential objective sleep markers of PTSD. If independently validated, these putative EEG markers may offer new targets for the development of sleep-specific PTSD diagnostics and interventions.


delta activity; gamma activity; high-density EEG; hyperarousal; post-traumatic stress disorder; power spectrum; sleep; sleep depth; topography


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