1066 Rapid Eye Movement (REM) Sleep Duration in Posttraumatic Stress Disorder (PTSD) Varies Dynamically and Directly Within the Individual With Indices of Sleep Consolidation and Parasympathetic Tone

Abstract

Abstract Introduction Autonomic arousal in posttraumatic stress disorder (PTSD) has been associated with functional hypoactivation of the medial prefrontal cortex and hyperactivity of the amygdala which can directly affect sleep physiology including REM sleep. REM sleep has been associated with reduced fear conditioning; and PTSD has been associated with REM sleep fragmentation. A case report of a drug-free PTSD patient (Gupta MA,2019) who underwent 10 home sleep apnea tests (HSATs) observed a dynamic and inverse relation between REM sleep duration and indices of sympathetic activation during sleep and sleep fragmentation. This study has examined the relationship between REM sleep duration and sleep parameters related to sleep consolidation and parasympathetic tone in 17 PTSD patients who had completed at least 10 HSATs each. Methods 17 civilian PTSD patients (all female; mean±SD age: 47.59±10.52 years; 16 white) each completed 10 HSATs (WatchPAT200, Itamar)(over 1 to 45 months). The mean±SD initial PTSD Checklist for DSM-5 score was 49.24±13.08 (n=17), and Clinician Administered PTSD Scale for DSM-5 (CAPS-5) score was ≥55. Patients using benzodiazepines and/or narcotics were excluded. Results The overall mean±SD REM duration for all 10 visits (for 17x10 HSATs) was 84.40±8.65 minutes (range 69.13-96.97 min); the mean REM duration over the 10 HSATs correlated with other sleep indices as follows: sleep onset latency (Pearson r= -0.667, p=0.035); sleep efficiency (r=0.636, p=0.048); light sleep (NI+N2) percentage (r= -0.754, p=0.012); light sleep duration (r=0.692, p=0.027);deep sleep (N3) duration (r=0.635, p=0.048). Conclusion Over the 10 HSATs the average (n=17) REM sleep duration was directly related to indices of sleep consolidation (decreased sleep latency, increased sleep efficiency, increase in both light and deep sleep duration). The direct relation of REM sleep duration to duration of deep sleep, and inverse relation with light sleep percentage suggests REM sleep- related promotion of increased parasympathetic tone within the individual. Support None