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Subjective
complaints of sleep disruption and distressing dreams are associated with
increased severity of posttraumatic stress disorder (PTSD), and poor PTSD
outcomes. Pathways underlying the relationship between sleep disturbances
(SD) and PTSD, however, remain elusive. Heightened arousal during
sleep (autonomic and cerebral) may constitute a mediating pathway underlying
this relationship. Prior laboratory-based sleep studies have failed
to consistently reveal gross PTSD-specific sleep anomalies indicative of
increased arousal. However, the variability of SD and PTSD severity
over time may influence PSG findings. Thus, prospective ecological
assessment of SD and PTSD are required to accurately characterize the psychophysiological
sleep correlates of PTSD. Ecological momentary assessment (EMA),
which involves frequent sampling of target behaviors and symptoms, can
provide a more accurate characterization of the relationship between SD
and PTSD severity and outcomes. Ambulatory polysomnographic studies
(APS) in the participant's natural sleep environment may provide further
naturalistic insights into the physiological pathways underlying the relationship
between SD and PTSD. Finally, probing physiological arousal by using
a brief SD-focused intervention can elucidate the mechanisms mediating
this relationship. The specific aims of this study are: 1)
To determine the feasibility of using EMA and APS in a sample of crime
victims with PTSD; 2) To prospectively and naturalistically characterize
the relationships between SD, PTSD severity, and heightened arousal during
sleep; and 3) To investigate the mediating role of heightened arousal by
using a brief non-pharmacological intervention as a probe. Consistent
with the PMBC's mission, this study will allow preliminary, prospective,
and ecologically valid evaluation of the psychophysiological mechanisms
underlying the relationship between SD and PTSD.  (PDF
VERSION)(MS
WORD VERSION)
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