A POLYSOMNOGRAPHIC COMPARISON OF VETERANS WITH COMBAT-RELATED PTSD, DEPRESSED MEN, AND NON-ILL CONTROLS

Post-traumatic stress disorder (PTSD) overlaps major depression (MD) c linically, but differs with respect to treatment response and some bio logical markers. Sleep disturbances represent core features of PTSD an d are also common in MD. Rapid eye movement sleep (REM) has been postu lated to be involved in the pathophysiology of PTSD, and REM abnormali ties occur in MD. Twenty-five patients with combat-related PTSD, 16 me n with a principal diagnosis of MD, and 10 asymptomatic male controls were compared by polysomnography (PSG) under medication and substance- free conditions. Data were obtained from recordings made after an acco modation night. One subject from each group was excluded for significa nt apnea or limb movements. Sleep efficiency was decreased in the PTSD group compared to the MD and control groups. REM density was comparab ly increased in PTSD and MD groups, while the amount of REM sleep was reduced in PTSD compared to MD groups. These sleep measures were not s ignificantly associated with co-morbid depression, substance-use disor der histories, or subclinical sleep apnea or limb movements within the PTSD group. These findings support sleep maintenance being impaired i n chronic PTSD patients. Increased REM density in PTSD patients was re plicated and was comparable to increases in the MD group. Divergence o f REM time between these clinical groups suggests the possibility of d ifferent underlying mechanisms.