Sleep and intrusive memories immediately after a traumatic event in emergency department patients

• Published in: Sleep (New York, N.Y.) Vol. 43; no. 8; p. 1
• Main Authors: Porcheret, Kate, Iyadurai, Lalitha, Bonsall, Michael B, Goodwin, Guy M, Beer, Sally A, Darwent, Melanie, Holmes, Emily A
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.08.2020
• Subjects: Emergency service; Emergency Service, Hospital; Hospitals; Humans; intrusive memories; Medicin och hälsovetenskap; Memory; mental imagery; Post traumatic stress disorder; posttraumatic stress disorder; Psychological Trauma; single symptom; Sleep; Sleep, Health, and Disease; Stress Disorders, Post-Traumatic - etiology; trauma; United Kingdom; sleep; trauma; intrusive memories; single symptom; mental imagery; posttraumatic stress disorder
• ISSN: 0161-8105; 1550-9109; 1550-9109
• DOI: 10.1093/sleep/zsaa033

Abstract Study objectives Intrusive memories of psychological trauma are a core clinical feature of posttraumatic stress disorder (PTSD), and in the early period post-trauma may be a potential target for early intervention. Disrupted sleep in the weeks post-trauma is associated with later PTSD. The impact of sleep and intrusive memories immediately post-trauma, and their relation to later PTSD, is unknown. This study assessed the relationship between sleep duration on the first night following a real-life traumatic event and intrusive memories in the subsequent week, and how these might relate to PTSD symptoms at 2 months. Methods Patients (n = 87) recruited in the emergency department completed a sleep and intrusive memory diary from the day of their trauma and for the subsequent week, with optional actigraphy. PTSD, anxiety, and depression symptoms were assessed at 1 week and 2 months. Results A U-shaped relationship was observed between sleep duration on the first night and intrusive memories over the subsequent week: sleeping “too little” or “too much” was associated with more intrusive memories. Individuals who met Clinician-Administered PTSD Scale (CAPS) criteria for PTSD at 2 months had three times more intrusive memories in the first week immediately post-trauma than those who did not (M = 28.20 vs 9.96). Post hoc analysis showed that the absence of intrusive memories in the first week post-trauma was only observed in those who did not meet CAPS criteria for PTSD at 2 months. Conclusions Monitoring intrusive memories and sleep in the first week post-trauma, using a simple diary, may help identify individuals more vulnerable to later psychopathology.