Objectives To examine if sleep problems act as a risk factor for future PTSD development in military, child, and general adult demographics. We will also be examining specific sleep disorders, such as nightmares and insomnia, as well as examining general sleep complaints in a series of sub-sections (REM sleep, Sleep duration, quality, latency, and maintenance) to see if it is possible with the current literature to discover potential hints into the development of PTSD.
Methods Six databases (Medline, Embase, Web of Science, Psych info, AMED, and OpenGray) were searched with a standardised search strategy. The papers were then screened for relevance and quality controlled using the Ottowa-Newcastle Scale and the CASP cohort checklist by two reviewers until only relevant and high quality cohort studies remained. Relevant information and data was extracted from published sources and information on insomnia, nightmares, REM sleep, and 4 specific sleep subcategories (sleep duration, quality, latency, and maintenance) were gathered and examined. Nometa-analysis was planned.
Results Out of the 1813 documents gathered from the various databases, 25 papers were deemed fit for narrative synthesis. 19 discussed insomnia or general sleep complaints, and found that those tended to correlate with development of future PTSD, with little distinction between if the insomnia appeared pre or post-trauma. 6 discussed nightmares and found that those too were predictive, and 2 discussed REM sleep and found that REM theta waves were potentially predictive.
Conclusion It is almost certain that complaints of poor sleep predict future PTSD development, with insomnia being predictive of many psychiatric conditions not just PTSD, and nightmares being more specific to the development of just PTSD. It has also been suggested that only subjectively (not objectively) poor sleep predicts PTSD. This would explain why specific sleep categories all have mostly mixed results, but the idea is not backed completely in the literature.
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