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A Nonpharmacologic Method for Enhancing Sleep in PTSD

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Technical Report,30 Sep 2014,29 Sep 2015

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University of Arizona Tucson United States

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Since 2001, more than 2 million U.S. military personnel have deployed in to Iraq and Afghanistan. Recent estimates suggest that between 17-20 of Soldiers returning from these conflicts meet criteria for posttraumatic stress disorderPTSD upon their return. Notably, sleep disturbance is one of the primary complaints of combat-related PTSD patients. Recent evidence suggests that sleep may play a critical role in the ability to effectively extinguish conditioned fear responses and is necessary for consolidating positively valenced emotional memories. Furthermore, many PTSD patients do not respond to currently available treatments, and sleep disturbance is a frequent residual symptom even among those patients who do respond. Thus, sleep disturbance, as a symptom of PTSD, may lead to a vicious circle that prevents full resolution of the conditioned fear responses, sustaining continuation of the disorder. Thus, rather than conceptualizing sleep problems as a secondary effect of PTSD, a novel approach would involve directly targeting and ameliorating the sleep problems, potentially leading to improved emotional regulation and symptom reduction. Although pharmacologic treatments for sleep problems exist, an alternative non-pharmacologic method to improve sleep is to phase shift and strengthen the circadian entrainment. Bright light therapy BLT, particularly in the blue wavelength, is an effective treatment for sleep and mood disorders, and is thought to exert its effects through suppression of hypothalamic melatonin production. Although preliminary data support the efficacy of BL therapy in treating PTSD, comprehensive randomized placebo-controlled trials are needed. This project aims to address such needs.

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