Changes in sleep architecture in German Armed Forces personnel with posttraumatic stress disorder compared with depressed and healthy control subjects

BACKGROUND: This study compares the sleep architecture of patients with posttraumatic stress disorder (PTSD) with that of both patients with depression and subjects with no mental disorder.

METHOD: 45 German armed forces personnel with PTSD, 72 German armed forces personnel with depression and 24 healthy control subjects underwent 24-hour polysomnography. The effects of group membership, medication and the statistical interaction of group and medication were analysed for the following variables: sleep onset latency, REM sleep latency, slow-wave sleep and REM sleep percentages.

RESULTS: Sleep onset latency was significantly prolonged in both the PTSD and the depression group. Moreover, psychotropic medication was associated with significantly prolonged REM sleep latency.

CONCLUSION: The impact on sleep onset latency is of special clinical relevance in that according to preliminary studies, it is of major importance for subjective sleep quality. In contrast to the other parameters, an increase in sleep onset latency results in a subjective reduction in sleep quality which can lead to hyperarousal and increased preoccupation with sleep, which in turn may lead to dysfunctional sleep patterns.