Nightmares and Sleep Disturbances in Children with PTSD: A Polysomnographic and Actigraphy Approach Evaluation

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 Oct 28

PMID 37892709

Authors

Julie Rolling

Juliette Rabot

Eve Reynaud

Oriane Kolb

Patrice Bourgin

Carmen M Schroder

Affiliations

Soon will be listed here.

Abstract

Rationale: Sleep disturbances (insomnia and nightmare symptoms) are the most sensitive and persistent symptoms of pediatric post-traumatic stress disorder (PTSD). Untreated, these sleep disturbances (SD) associated with PTSD are predictive of PTSD persistence and increased psychiatric complications. The aim of this study was to evaluate sleep and circadian rhythms in children with PTSD under both laboratory and ecological conditions in comparison with a control population and to test for the first time the hypothesis that SD and circadian rhythms are positively correlated with PTSD severity and its comorbidities.

Method: This prospective pilot study evaluated PTSD, SD (insomnia, nightmares), and sleep-wake rhythms in 11 children with PTSD (aged 3-18), compared with the age and sex-matched control groups. Assessment of PTSD and subjective and objective measures of sleep and sleep-wake rhythms (questionnaires, 24-h in-laboratory video-polysomnography, 15-day at-home actigraphy recording) were performed between 1 and 6 months after the traumatic event.

Results: Children with PTSD had higher sleep fragmentation (increased wake-after-sleep onset, increased number of sleep stage changes) compared to controls, with a change in sleep microarchitecture (micro-arousal index at 14.8 versus 8.2, = 0.039). Sleep fragmentation parameters correlated with PTSD symptomatology, insomnia, and post-traumatic nightmare severity. The within-group comparison revealed a better sleep architecture in the controlled (sleep laboratory) than in the ecological condition (at home) (total sleep time 586 versus 464 min, = 0.018).

Conclusions: Sleep and rhythm disturbances are strongly associated with PTSD in children. The assessment of SD in children with PTSD should be carried out systematically and preferentially under ecological conditions, and management of SD should integrate the environment (environmental design, psycho-education for the children and their parents) more fully into therapy focused on sleep and trauma.

Citing Articles

Sleep Quality and Cognitive Impairments in Children and Adolescents with Post Traumatic Stress Disorder and/or Depressive Symptoms.

Barrera-Valencia M, Calderon-Delgado L, Adan A J Clin Med. 2025; 14(3).

PMID: 39941679 PMC: 11818455. DOI: 10.3390/jcm14031010.

Chronobiology in Paediatric Neurological and Neuropsychiatric Disorders: Harmonizing Care with Biological Clocks.

Giannotta G, Ruggiero M, Trabacca A J Clin Med. 2025; 13(24.

PMID: 39768659 PMC: 11678831. DOI: 10.3390/jcm13247737.

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