Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Aug:40:195-212.
doi: 10.1016/j.cpr.2015.05.008. Epub 2015 Jun 3.

Sleep disturbances, TBI and PTSD: Implications for treatment and recovery

Karina Stavitsky Gilbert  1 , Sarah M Kark  2 , Philip Gehrman  3 , Yelena Bogdanova  4
Affiliations
Review

Sleep disturbances, TBI and PTSD: Implications for treatment and recovery

Karina Stavitsky Gilbert et al. Clin Psychol Rev. 2015 Aug.

Abstract

Post-Traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), and sleep problems significantly affect recovery and functional status in military personnel and Veterans returning from combat. Despite recent attention, sleep is understudied in the Veteran population. Few treatments and rehabilitation protocols target sleep, although poor sleep remains at clinical levels and continues to adversely impact functioning even after the resolution of PTSD or mild TBI symptoms. Recent developments in non-pharmacologic sleep treatments have proven efficacious as stand-alone interventions and have potential to improve treatment outcomes by augmenting traditional behavioral and cognitive therapies. This review discusses the extensive scope of work in the area of sleep as it relates to TBI and PTSD, including pathophysiology and neurobiology of sleep; existing and emerging treatment options; as well as methodological issues in sleep measurements for TBI and PTSD. Understanding sleep problems and their role in the development and maintenance of PTSD and TBI symptoms may lead to improvement in overall treatment outcomes while offering a non-stigmatizing entry in mental health services and make current treatments more comprehensive by helping to address a broader spectrum of difficulties.

Keywords: Actigraphy; Cognition; Interventions; Neuromodulation; PTSD; Paradoxical insomnia; Sleep; Sleep physiology; TBI; Veterans.

PubMed Disclaimer

Conflict of interest statement

All authors declare that they have no conflicts of interest.

References

    1. American Academy of Sleep Medicine. International Classification of Sleep Disorders – Third Edition (ICSD-3) 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014.
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth ed. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.
    1. Armed Forces Health Surveillance Center (AFHSC) Incident diagnoses of common symptoms (“sequelae”) following traumatic brain injury, active component, U.S. Armed Forces, 2000–2012. Medical Surveillance Monthly Report. 2013;20(6):9–13. - PubMed
    1. Arnedt JT, Cuddihy L, Swanson LM, Pickett S, Aikens J, Chervin RD. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. Sleep. 2013;36(3):353–362. - PMC - PubMed
    1. Ayalon L, Borodkin K, Dishon L, Kanety H, Dagan Y. Circadian rhythm sleep disorders following mild traumatic brain injury. Neurology. 2007;68(14):1136–1140. - PubMed

Publication types

MeSH terms