Sleep, stress and trauma

Valentina Socci 1, Rodolfo Rossi 2, Dalila Talevi 1, Claudio Crescini 1, Daniela Tempesta 1, Francesca Pacitti 1

1 Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Italy; 2 Department of System Medicine, University of Rome Tor Vergata, Italy

The potential impact of sleep and sleep disorders on stress responses has received increasing interest particularly in the context of Post-traumatic Stress Disorder (PTSD). This review aims at synthesizing current evidence concerning the link between trauma exposure, sleep, emotional regulation and stress. In the last decades, experimental investigations suggested a critical role of sleep on emotional memory formation and emotional reactivity; similarly, animal and human studies highlighted the relations between sleep and fear responses, supporting the notion that sleep disturbance plays an important role in PTSD-relevant processes such as fear learning and extinction. Although some crucial aspects of these interactions need further clarification, convincing evidence now suggests a complex physiological interaction of stress response and sleep. In the context of trauma-related disorders, sleep alterations have been suggested as core symptoms as well as risk and prognostic factors; importantly, sleep may also represent an important therapeutic target in mental health. However, evidence accumulated so far points to sleep disturbance as a marker not only of PTSD, but also of increased vulnerability to maladaptive stress responses. Novel models conceptualize sleep disturbance as a modifiable, transdiagnostic risk factor for mental disorders, with important theoretical and clinical implications. 

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