It has also been shown that pretraumatically disturbed sleep may be a risk factor for later developing PTSD. This relationship between PTSD and sleep disorders is suggested to be bidirectional. Studies in recent years have expanded upon the classic model of PTSD namely in considering sleep disorders as symptoms of PTSD insofar as sleep seems to be of major importance regarding the development and course of the disorder. Whether early sleep interventions exert a preventive effect on the development of PTSD remains to be clarified in future studies. Effective therapy for sleep disturbances may consequently also improve well-being during the day and probably even the course of PTSD. For nondrug interventions, challenges arise from the current lack of PTSD-treatment concepts integrating sleep- and trauma-focused therapies. However, there is little empirical evidence on the effectiveness of long-term drug treatment for insomnia and nightmares. The complex etiology and symptomatology of trauma-related sleep disorders with frequent psychiatric comorbidity require the application of multimodal treatment concepts, including psychological and pharmacological interventions. In addition, sleep disorders, such as sleep-related breathing disorders and parasomnias are frequent comorbid conditions. Polysomnographic measurements reveal alterations of the sleep architecture and fragmentation of rapid eye movement sleep. With regard to sleep quality, insomnia and nocturnal anxiety symptoms, as well as nightmares and stressful dreams, are the most prominent sleep symptoms.
The relationship seems to be bidirectional, and persistent disturbed sleep may influence the course of the disorder. Sleep disorders and nightmares are core symptoms of post-traumatic stress disorder (PTSD).
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