Neurofeedback Tunes Key Brain Networks, Improving Well-Being in PTSD

Dec. 3, 2013 —

Science Daily/University of Western Ontario

Pioneering research conducted at Western University points to a promising avenue for the treatment of post-traumatic stress disorder (PTSD): utilising neurofeedback training to alter the plasticity of brain networks linked to the condition.

uring neurofeedback, intentional control of one's own brain activity may be learned with what's called a brain-computer interface, which is able to represent graphically a person's real-time brain activation on a computer. This can be done noninvasively with brainwave activities, for example, where the computer monitor behaves like a virtual "mirror" to real electrical oscillations produced by neurons in the cortex. These are recorded by surface sensors on the scalp, also known as an electroencephalogram (EEG).

Senior author and principal investigator Dr. Ruth Lanius, a professor at the Department of Psychiatry at Western's Schulich School of Medicine & Dentistry and a scientist with Lawson Health Research Institute, adds "The last decade of neuroscience research has offered a deeper understanding of the key brain networks involved in cognitive and emotional functions.

We are now on the threshold of being able to use this information to understand the neural mechanisms underlying certain disorders and their treatments. Neurofeedback offers great promise as a type of brain training that is directly based on the functional activation of these brain networks. We are therefore thrilled to see the first evidence of this in action, along with significant changes in subjective well-being. Our hope and vision for the future is that this approach could improve and potentially augment PTSD treatment."

http://www.sciencedaily.com/releases/2013/12/131203112213.htm

Children significantly more likely to develop PTSD if mother afflicted

- November 27, 2013

Science Daily/American Associates, Ben-Gurion University of the Negev

While fewer than 10 percent (8.4 percent) of the mothers were suffering from PTSD, more than a fifth (21 percent) of their children presented PTSD symptoms in a recent study on the topic. Children who developed PTSD symptoms also had more psychosomatic complaints such as constipation, diarrhea and headaches.

In the study published in the Journal of Depression & Anxiety, while fewer than 10 percent (8.4 percent) of the mothers were suffering from PTSD, more than a fifth (21 percent) of their children presented PTSD symptoms. Children who developed PTSD symptoms also had more psychosomatic complaints such as constipation, diarrhea and headaches.

"This study reinforces the existing body of knowledge regarding the importance of evaluating and treating parental responses in time of stress," the researchers explain.

"Parents are often the key to understanding children's responses generally and specifically in times of stress. The study also highlights the close interrelations between 'body and soul' among children and adults."

In the study, some 160 mothers of preschool children were interviewed about symptoms exhibited by their children and their own responses during Operation Cast Lead. More than 750 rockets were fired into Southern Israel from Gaza from December 2008 to January 2009.

Working with the Preschool Psychiatric Unit at Soroka University Medical Center, the BGU researchers examined the relationship between PTSD symptoms and socio-demographic, family attributes and psychosomatic symptoms among children exposed to Grad missile attacks in Beer-Sheva, Israel.

http://www.sciencedaily.com/releases/2013/11/131127110607.htm

PTSD raises risk for obesity in women

- November 20, 2013

Science Daily/Columbia University's Mailman School of Public Health

Women with post-traumatic stress disorder (PTSD) gain weight more rapidly and are more likely to be overweight or obese than women without the disorder, find researchers. It is the first study to look at the relationship between PTSD and obesity over time.

One in nine women will have PTSD at sometime over the course of their lifetime -- twice as often as men. Women are also more likely to experience extreme traumatic events like rape that carry a high risk for the disorder.

"PTSD is not just a mental health issue," says study senior author Karestan Koenen, PhD, Mailman School associate professor of Epidemiology. "Along with cardiovascular disease and diabetes, we can now add obesity to the list of known health risks of PTSD."

"The good news from the study is that it appears that when PTSD symptoms abate, risk of becoming overweight or obese is also significantly reduced," says first author Laura D. Kubzansky, PhD, Professor of Social and Behavioral Sciences at Harvard School of Public Health. However, despite the growing evidence of potential far-reaching problems associated with PTSD, it's estimated that only half of women in the United States with the disorder are ever treated. "Hopefully, wider recognition that PTSD can also influence physical health will improve this statistic, leading to better screening and treatments, including those to prevent obesity," says Dr. Kubzansky.

Normal-weight women who developed PTSD during the study period had 36% increased odds of becoming overweight or obese compared with women who experienced trauma but had no symptoms of PTSD. The higher risk was evident even for women with sub-threshold symptoms levels and remained after adjusting for depression, which has also been proposed as a major risk factor for obesity. In women with PTSD that began prior to the study period, body mass index increased at a more rapid pace than women without PTSD.

The observed effect of PTSD on obesity is likely stronger in the general population of women than in nurses, notes Dr. Koenen. "Nurses are great for studies because they report health measures like BMI with a high degree of accuracy. But they are also more health conscious and probably less likely to become obese than most of us, which makes these results more conservative than they would otherwise be."

Symptoms of PTSD rather than the trauma itself seemed to be behind the weight gain. "We looked at the women who developed PTSD and compared them to women who experienced trauma but did not develop PTSD. On the whole, before their symptoms emerged, the rate of change in BMI was the same as the women who never experienced trauma or did experience trauma but never developed symptoms," says Dr. Kubzansky.

How exactly does PTSD lead to weight gain? The biological pathway is unknown, but scientists have a number of guesses. One is through the over-activation of stress hormones. PTSD may lead to disturbances in functioning of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, each of which are involved in regulating a broad range of body processes, including metabolism. Another is through unhealthy behavior patterns that may be used to cope with stress. Ongoing research is looking at whether PTSD increases women's preference for processed foods and decreases their likelihood of exercising.

http://www.sciencedaily.com/releases/2013/11/131120192339.htm

Teens from military families suffer from deployments

- November 19, 2013

Science Daily/Health Behavior News Service

Teens that have had a parent or sibling on military deployment were more likely to have suicidal thoughts or be depressed than teens without military connections, finds a new study.

"We've been in the longest war in recent history with increased numbers of individuals experiencing combat and being deployed for longer periods of time -- and multiple times," says study co-author Julie Cederbaum, Ph.D., a researcher at the University of Southern California. "We are logically thinking about the adult that is being deployed, but we're not talking enough about the kids left behind and how they might manage the military experience of their parent."

More than 13 percent of the teens surveyed had a parent or sibling in the military. Teens who had experienced just one deployment of a parent or sibling were 40 percent more likely to feel sad or hopeless, 24 percent more likely to have suicidal thoughts and 15 percent more likely to be depressed than teens that did not have military connections.

"You see an even bigger shift with two or more deployments," Cederbaum says. "These kids were 56 percent more likely to experience feelings of sadness or hopelessness, 34 percent to have thought about suicide and 41 percent more likely to experience depressive symptoms."

Anita Chandra, Ph.D., a researcher at the RAND Corporation who has extensively studied military families says that there are many important factors that influence the mental health of teens with military connections, including the teens' age, the total number of months a parent is deployed and whether the parent was deployed into combat. Reintegration -- when a parent returns home -- can be an emotionally difficult time for military families, as well.

Additionally, Chandra notes, not all mental health findings of teens with military connections are negative. "We also know that kids in these families have exhibited a lot of rebound and recovery from deployment stress and a lot of resilience."

Even though the Iraq war ended in 2011 and American troops are withdrawing from Afghanistan, the mental health of children in military families is likely to remain an important issue.

"While many deployed service members return home with minimal reintegration issues, we know that a fair number of folks coming back from deployment aren't doing particularly well," says Cederbaum. "Their children may now be in a home where there's potential traumatic brain injury, mental distress, or substance misuse. That service member or veteran is going through an adjustment and the family has to readjust as well."

Increasing mental health screenings in pediatric and school settings and creating a safe environment for teens of military families to talk about their experiences and feel supported are ways to help identify and reach at-risk youth, Cederbaum says.

http://www.sciencedaily.com/releases/2013/11/131119193439.htm

Taking stock of research on sleepless soldiers

October 16, 2013

Science Daily/Springer

Various behavioral treatment options are helping to treat the sleeplessness experienced by American soldiers who have been deployed in recent military operations. A review of research has been done on deployment-related insomnia among military personnel and veterans, conducted since 2010.

Insomnia is reported by up to 54 percent of the two million men and women who have served in various American combat efforts since 11 September 2001, compared to up to 22 percent of civilian adults. Although it is possible that a person's insomnia may develop prior to joining the military, it can also occur during the service period, or post-deployment when the soldier returns to civilian life. Studies have found that deployment-related stressors like combat exposure, mild traumatic brain injury, irregular sleep/wake schedules and the adjustment of returning home, all contribute to sleeplessness.

Soldiers who suffer from insomnia while being deployed have a bigger chance of developing traumatic stress reactions such as depression and posttraumatic stress disorders, and even committing suicide. Also, it contributes to physical war-related injuries.

Behavioral interventions such as cognitive-behavioral therapy and imagery rehearsal therapy often yield positive results in trying to reduce the effects of insomnia and nightmares, respectively. These treatments can be delivered during in-person sessions with clinicians, brief follow up sessions via telephone, or online and mobile resources. Training was recently rolled out to prepare providers in the Veterans Health Administration to use cognitive behavioral treatment of insomnia.

The goal is to eventually educate 1,000 clinicians in an effort to bridge the gap between veterans who need treatment, and available providers. Training of clinicians in military settings and other non-VA clinics is equally important to meet the needs of our service members and veterans.

"Training providers to be knowledgeable about insomnia and behavioral treatment options is a vital component to the treatment of chronic insomnia and managing its impact on other disorders," say the authors, who believe more research is needed on methods to increase access to care.

"In addition to research and clinical efforts specifically for service members and veterans, research and clinical efforts directed at military family members are also important components in providing the care needed and promoting health and recovery among service members and their families."

http://www.sciencedaily.com/releases/2013/10/131016123732.htm

Insomnia Linked to PTSD and Other Mental Disorders After Military Deployment

June 28, 2013 —

Science Daily/Perelman School of Medicine at the University of Pennsylvania

A new study from the Perelman School of Medicine at the University of Pennsylvania and the Naval Health Research Center has shown Military service members who have trouble sleeping prior to deployments may be at greater risk of developing posttraumatic stress disorder (PTSD), depression and anxiety once they return home. The new study, published in the July 2013 issue of the journal SLEEP, found that pre-existing insomnia symptoms conferred almost as a large of a risk for those mental disorders as combat exposure.

"Understanding environmental and behavioral risk factors associated with the onset of common major mental disorders is of great importance in a military occupational setting," said lead study author Philip Gehrman, PhD, assistant professor of Psychology in the Department of Psychiatry, member of the Penn Sleep Center, and the Philadelphia VA Medical Center. "This study is the first prospective investigation of the relationship between sleep disturbance and development of newly identified positive screens for mental disorders in a large military cohort who have been deployed in support of the recent operations in Iraq or Afghanistan."

"One of the more interesting findings of this study is not only the degree of risk conferred by pre-deployment insomnia symptoms, but also the relative magnitude of this risk compared with combat-related trauma," says Gehrman. "The risk conferred by insomnia symptoms was almost as strong as our measure of combat exposure in adjusted models."

The researchers also found that short sleep duration (less than six hours of sleep per night), separate from general insomnia, was associated with new-onset PTSD symptoms.

"We found that insomnia is both a symptom and a risk factor for mental illness and may present a modifiable target for intervention among military personnel," says Gehrman. "We hope that by early identification of those most vulnerable, the potential exists for the designing and testing of preventive strategies that may reduce the occurrence of PTSD, anxiety, and depression."

The research team says that additional study is needed to investigate whether routine inquiry about insomnia symptoms and application of appropriate early, effective interventions reduces subsequent morbidity from mental disorders. They note that in a military population, assessment of insomnia symptoms could easily be incorporated into routine pre-deployment screening.

http://www.sciencedaily.com/releases/2013/06/130628160829.htm

Half of Those Diagnosed with PTSD Also Suffer from Depression

June 4, 2013 —

Science Daily/Case Western Reserve University

About one of every two people diagnosed with posttraumatic stress disorder (PTSD) also suffer symptoms of depression, according to new research by Case Western Reserve University's Department of Psychological Sciences.

The analysis also concludes that both genders diagnosed with PTSD equally suffer from depression. Since women tend to report more symptoms of depression than men, this contradicts a general belief that women are more inclined to struggle with both.

The findings were based on an analysis of 57 peer-reviewed studies, representing data on 6,670 people (civilians and military personnel) who suffered from PTSD. Researchers conclude that 52 percent of the PTSD cases also reported symptoms of depression.

Before the study, estimates for individuals having both major depression disorder (MDD) and PTSD had ranged anywhere from 20 to 80 percent.

The research represents the first comprehensive analysis of peer-reviewed literature on people with PTSD and MDD.

PTSD is an anxiety disorder resulting from a traumatic incident in which flashbacks or unshakable thoughts about the trauma are common. MDD is characterized by an overwhelming and lingering sense of sadness and hopelessness. Symptoms can range from "feeling the blues" to thoughts of suicide.

"If individuals do not get a comprehensive assessment of what's bothering them, one or the other can be missed," said Case Western Reserve research associate Nina Rytwinski, the study's lead investigator and a researcher with the National Institute of Mental Health-funded PTSD project directed by Norah Feeny, PhD, from Case Western Reserve University and Lori Zoellner, PhD, from the University of Washington. "This high co-occurrence rate accentuates the importance of routinely assessing for both disorders."

The findings also suggest important implications for improving how men with PTSD are treated. Health-care providers tend to identify depression more frequently in women, while men can exhibit symptoms of depression that are misattributed to PTSD, Rytwinski said.

"The biases against men with PTSD symptoms put them at risk for under diagnosis and under treatment of a major depressive disorder," she said.

Researchers narrowed about 1,500 studies on PTSD and MDD to the 57 published peer-reviewed studies. They focused on research about individuals who had experienced some physical or sexual assault trauma.

By recognizing how frequently people experience both disorders, clinicians may better address barriers to completing therapy, personalized treatment and overall care, the researchers report.

http://www.sciencedaily.com/releases/2013/06/130604153515.htm

Combat Veterans Suffering from PTSD, 'Fear Circuitry' in the Brain Never Rests

May 18, 2013 —

Science Daily/NYU Langone Medical Center

Chronic trauma can inflict lasting damage to brain regions associated with fear and anxiety. Previous imaging studies of people with post-traumatic stress disorder, or PTSD, have shown that these brain regions can over-or under-react in response to stressful tasks, such as recalling a traumatic event or reacting to a photo of a threatening face. Now, researchers at NYU School of Medicine have explored for the first time what happens in the brains of combat veterans with PTSD in the absence of external triggers.

Their results, published in Neuroscience Letters, and presented today at the annual meeting of the American Psychiatry Association in San Francisco, show that the effects of trauma persist in certain brain regions even when combat veterans are not engaged in cognitive or emotional tasks, and face no immediate external threats. The findings shed light on which areas of the brain provoke traumatic symptoms and represent a critical step toward better diagnostics and treatments for PTSD.

A chronic condition that develops after trauma, PTSD can plague victims with disturbing memories, flashbacks, nightmares and emotional instability. Among the 1.7 million men and women who have served in the wars in Iraq and Afghanistan, an estimated 20% have PTSD. Research shows that suicide risk is higher in veterans with PTSD. Tragically, more soldiers committed suicide in 2012 than the number of soldiers who were killed in combat in Afghanistan that year.

"It is critical to have an objective test to confirm PTSD diagnosis as self reports can be unreliable," says co-author Charles Marmar, MD, the Lucius N. Littauer Professor of Psychiatry and chair of NYU Langone's Department of Psychiatry. Dr. Marmar, a nationally recognized expert on trauma and stress among veterans, heads The Steven and Alexandra Cohen Veterans Center for the Study of Post-Traumatic Stress and Traumatic Brain Injury at NYU Langone Medical Center.

The study, led by Xiaodan Yan, a research fellow at NYU School of Medicine, examined "spontaneous" or "resting" brain activity in 104 veterans of combat from the Iraq and Afghanistan wars using functional MRI, which measures blood-oxygen levels in the brain. The researchers found that spontaneous brain activity in the amygdala, a key structure in the brain's "fear circuitry" that processes fearful and anxious emotions, was significantly higher in the 52 combat veterans with PTSD than in the 52 combat veterans without PTSD. The PTSD group also showed elevated brain activity in the anterior insula, a brain region that regulates sensitivity to pain and negative emotions.

Moreover, the PTSD group had lower activity in the precuneus, a structure tucked between the brain's two hemispheres that helps integrate information from the past and future, especially when the mind is wandering or disengaged from active thought. Decreased activity in the precuneus correlates with more severe "re-experiencing" symptoms -- that is, when victims re-experience trauma over and over again through flashbacks, nightmares and frightening thoughts.

http://www.sciencedaily.com/releases/2013/05/130518153257.htm

Posttraumatic Stress Disorder Associated with Type 2 Diabetes

May 16, 2013 —

Science Daily/Helmholtz Zentrum Muenchen - German Research Centre for Environmental Health

The presence of posttraumatic stress disorder is significantly associated with the development of type 2 diabetes. This is the finding of scientists from the Helmholtz Zentrum München and the University Hospital Gießen and Marburg who worked with data from the population-based KORA cohort study. A sustained activation of the hormonal stress axis due to chronic stress symptoms is most likely a major causing mechanism.

People suffering from posttraumatic stress disorder (PTSD) have a significant risk of developing type 2 diabetes. PTSD is a prolonged stress response syndrome whose symptoms develop in the aftermath of extremely stressful life events of exceptionally threatening or catastrophic nature.

A correlation between stress from mental illnesses and diabetes mellitus has already been under discussion for some time, but now Dr. Karoline Lukaschek from the Institute of Epidemiology II (EPI II) at the Helmholtz Zentrum München (HMGU) and Prof. Johannes Kruse from the Department of Psychosomatic Medicine and Psychotherapy, University Hospital Gießen and Marburg, and their colleagues have been able to provide the first proof of a significant association between the two illnesses.

The development of new approaches to the diagnosis, therapy and prevention of major widespread diseases such as diabetes mellitus are goals of the Helmholtz Zentrum München. Almost ten percent of the population in Germany is affected by diabetes mellitus. The study was supported by the Competence Network Diabetes Mellitus and the German Center for Diabetes Research (DZD), in which the Helmholtz Zentrum München is a partner.

http://www.sciencedaily.com/releases/2013/05/130516063839.htm

Mindfulness Therapy Might Help Veterans with Combat-Related PTSD

Apr. 17, 2013 —

Science Daily/University of Michigan Health System

Mindfulness exercises that include meditation, stretching, and acceptance of thoughts and emotions might help veterans with combat-related post-traumatic stress disorder find relief from their symptoms.

A new collaborative study from the University of Michigan Health System and the VA Ann Arbor Healthcare System shows that veterans with PTSD who completed an 8-week mindfulness-based group treatment plan showed a significant reduction in symptoms as compared to patients who underwent treatment as normal.

Mindfulness-based cognitive therapy, or MBCT, combines the practice of cognitive therapy with the meditative approach of mindfulness that stresses an increased awareness of all thoughts and emotions.

Previous research has shown stress reduction classes that use mindfulness meditation have been beneficial to people with a history of trauma exposure -- including veterans, civilians with war-related trauma and adults with a history of childhood sexual abuse -- but the new study is the first to examine the effect of mindfulness-based psychotherapy for PTSD with veterans in a PTSD clinic.

The study was published online today in Depression and Anxiety.

"The results of our trial are encouraging for veterans trying to find help for PTSD," says Anthony P. King, Ph.D., the study's lead author and research assistant professor in the U-M Department of Psychiatry, who performed the study in collaboration with psychologists at the VA Ann Arbor Healthcare System. "Mindfulness techniques seemed to lead to a reduction in symptoms and might be a potentially effective novel therapeutic approach to PTSD and trauma-related conditions."

Veterans in the mindfulness treatment groups participated in in-class exercises such as mindful eating, in which they focus on sensations associated with eating very slowly; "body scanning," an exercise where patients focus on physical sensations in individual parts of the body, paying special attention to pain and tension; mindful movement and stretching; and "mindfulness meditation" including focusing on the breath and emotions. The participants were also instructed to practice mindfulness at home through audio-recorded exercises and during the day while doing activities such as walking, eating and showering.

After eight weeks of treatment, 73 percent of patients in the mindfulness group displayed meaningful improvement compared to 33 percent in the treatment-as- usual groups.

King says the most noticeable area of improvement for patients in the mindfulness group was a reduction in avoidance symptoms. One of the main tenets of mindfulness therapy is a sustained focus on thoughts and memories, even ones that might be unpleasant.

"Part of the psychological process of PTSD often includes avoidance and suppression of painful emotions and memories, which allows symptoms of the disorder to continue," King says. "Through the mindfulness intervention, however, we found that many of our patients were able to stop this pattern of avoidance and see an improvement in their symptoms."

Mindfulness techniques also emphasize focus and attention to positive experiences and nonjudgmental acceptance to one's thoughts and emotions. Because of this, the researchers found that the patients in the mindfulness group experienced a decrease in feelings of self-blame and a trend toward decreased perception of the world as a dangerous place.

King says the results of this pilot study are encouraging, but further studies with a larger sample size are needed to fully explore the breadth of mindfulness intervention benefits. He added that the U-M-VA group is currently conducting a larger study including military veterans returning from Iraq and Afghanistan.

"Further studies will help us understand whether mindfulness training is more aptly considered an adjunct option to gold-standard trauma-focused treatments such as prolonged exposure or EMDR, or whether it can function as an intervention in its own right for treating avoidance and other symptoms," he says.

"Either way, mindfulness-based therapies provide a strategy that encourages active engagement for participants, are easy to learn and appear to have significant benefits for veterans with PTSD."http://www.sciencedaily.com/releases/2013/04/130417130007.htm

Most Effective PTSD Therapies Are Not Being Widely Used

Apr. 11, 2013 —

Science Daily/Association for Psychological Science

Post-traumatic stress disorder affects nearly 8 million adults in any given year, federal statistics show. Fortunately, clinical research has identified certain psychological interventions that effectively ameliorate the symptoms of PTSD. But most people struggling with PTSD don't receive those treatments, according to a new report published in Psychological Science in the Public Interest.

Recent history offers prime examples of that trend. More than 273,000 Iraq and Afghanistan war veterans have sought treatment for post-traumatic stress disorder over the past decade, the U.S. Department of Veterans Affairs reports. Researchers at Harvard Medical School found that at least one-third of residents in the path of Hurricane Katrina suffered some form of post-traumatic stress after the 2005 storm. And in the two months following last year's tragic mass shooting at Sandy Hook Elementary School in Connecticut, more than 16 percent of Newtown, Connecticut's police force had missed work because of PTSD-related issues, according to news reports.

"Not counting traumatic events that are experienced by individuals as opposed to entire populations, the number of people who need help for their PTSD and related symptoms is mind boggling," Foa and her co-authors write. "Thus PTSD treatment researchers are acutely aware of the tremendous need to disseminate effective treatments widely such that patients have access to them, and are also aware of the challenges to successfully meet this need."

http://www.sciencedaily.com/releases/2013/04/130411152401.htm

Police and firefighters at higher risk for mental disorders following traumatic events

February 26, 2013

Science Daily/Johns Hopkins University Bloomberg School of Public Health

New research suggests that exposure to diverse types of traumatic events among protective services workers is a risk factor for new onset of psychopathology and alcohol use disorders.

"Our findings suggest that exposure to diverse types of traumatic events among protective services workers is a risk factor for new onset of psychopathology and alcohol use disorders," said Christopher N. Kaufmann, MHS, lead author of the study and a doctoral student in the Bloomberg School's Department of Mental Health.

"When we examined the relationship of exposure to common traumas with the development of mood, anxiety and alcohol use disorders among protective services workers, we found that these workers were at greater risk for developing a mood or alcohol use disorder.

Interestingly, this relationship was not seen in those who had been in these jobs for a longer period, but was strong and statistically significant in workers who recently joined the profession. Developing curricula in coping skills and providing timely interventions for early career protective services workers may help reduce future psychiatric morbidity in these workers."

http://www.sciencedaily.com/releases/2013/02/130226141256.htm

Active Duty Military Personnel Prone to Sleep Disorders and Short Sleep Duration

Jan. 31, 2013 —

Science Daily/American Academy of Sleep Medicine

A new study found a high prevalence of sleep disorders and a startlingly high rate of short sleep duration among active duty military personnel. The study suggests the need for a cultural change toward appropriate sleep practices throughout the military.

"While sleep deprivation is part of the military culture, the high prevalence of short sleep duration in military personnel with sleep disorders was surprising," said Vincent Mysliwiec, MD, the study's principal investigator, lead author and chief of Pulmonary, Critical Care and Sleep Medicine at Madigan Army Medical Center in Tacoma, Wash. "The potential risk of increased accidents as well as long-term clinical consequences of both short sleep duration and a sleep disorder in our population is unknown."

Results show that the majority of participants (85.1 percent) had a clinically relevant sleep disorder. Obstructive sleep apnea (OSA) was the most frequent diagnosis (51.2 percent), followed by insomnia (24.7 percent). Participants' mean self-reported home sleep duration was only 5.74 hours per night, and 41.8 percent reported sleeping five hours or less per night. According to the AASM, individual sleep needs vary; however, most adults need about seven to eight hours of nightly sleep to feel alert and well-rested during the day.

According to the authors, this is the first study to systemically describe primary sleep disorders and associated comorbidities in accordance with standardized diagnostic criteria in a large cohort of military personnel referred with sleep complaints.

The study, appearing in the February issue of the journal SLEEP, involved a retrospective cross-sectional cohort analysis of 725 diagnostic polysomnograms performed in 2010 at Madigan Army Medical Center. Study subjects were active duty military personnel from the U.S. Army, Air Force and Navy, comprising mostly men (93.2%) and combat veterans (85.2%). Sleep disorder diagnoses were adjudicated by a board certified sleep medicine physician.

Results also show that 58.1 percent of the military personnel had one or more medical comorbidities, determined by medical record review. The most common service-related illnesses were depression (22.6%), anxiety (16.8%), post-traumatic stress disorder (13.2%), and mild traumatic brain injury (12.8%). Nearly 25 percent were taking medications for pain. Participants with PTSD were two times more likely to have insomnia, and those with depression or pain syndrome were about 1.5 times more likely to have insomnia.

"Mysliwiec and colleagues have made a significant contribution to our understanding of the link between sleep disorders and service-related illnesses associated with combat operations," Nita Lewis Shattuck, PhD, and Stephanie A.T. Brown, MS, postgraduate students at the Naval Postgraduate School in Monterey, Calif., wrote in a commentary on the study. "Their findings highlight the need for policy and culture change in our military organizations and continued research to understand and ameliorate the injuries these veterans have sustained. Better appreciation of the causal factors associated with veteran's health will lead to better policies for transition to civilian life and ultimately minimize the cost of veterans' health care to society."

http://www.sciencedaily.com/releases/2013/01/130131154408.htm

Brainwave training boosts network for cognitive control and affects mind-wandering

- October 24, 2012

Science Daily/University of Western Ontario

A breakthrough study has found that training of the well-known brainwave in humans, the alpha rhythm, enhances a brain network responsible for cognitive-control. The training technique, termed neurofeedback, is being considered as a promising new method for restoring brain function in mental disorders such as attention deficit hyperactivity disorder, schizophrenia, depression and post-traumatic stress disorder.

During neurofeedback, users learn to control their own brain activity with the help of a brain-computer interface. In the simplest case, this consists of a computer that records brainwaves through surface sensors on the scalp, known as an EEG (electroencephalogram).

The system is then able to process and simultaneously represent a user's real-time brain activity, displayed from moment-to-moment during a training game on a computer. This setup is known as a neurofeedback loop, because information of brain activity is continually fed-back to a user reflecting their level of control. Such real-time feedback allows users to reproduce distinct brain states under physiologically-normal conditions, promising to be an innovative way to foster brain changes without adverse effects. This is possible because of neuroplasticity, a natural property of the brain that enables it to reorganise after continual training, resulting from adjustments to its own activity.

The new findings firstly help to address a long-standing issue in the field: whether neurofeedback training can trigger any brain changes at all? "The effects we observed were durable enough to be detected with functional MRI up to 30 minutes after a session of neurofeedback which allowed us to compare brain and behavioral measures more closely in time," says Tomas Ros, PhD, lead author of the study, now at University of Geneva.

"We were excited to find that increased metabolic coupling within a key cognitive network was reflected in the individual level of brainwave change provoked by neurofeedback. The same measures were found to be tightly correlated with reductions in mind-wandering during an attention task. Amazingly, this would imply that the brain's function may be entrained in a direction that is more attentive and quiet. In other words, our findings speak for the exquisite functional plasticity of the adult brain, whose past activity of little more than 30 minutes ago can condition its future state of processing. This has already been hinted at in meditation research, but we arrived at a direct and explicit demonstration by harnessing a brain-computer interface."

http://www.sciencedaily.com/releases/2012/10/121024124741.htm

Missing Link Between Mental Health Disorders and Diseases in Iraq War Refugees

Oct. 15, 2012 —

Science Daily/Wayne State University - Office of the Vice President for Research

Wayne State University School of Medicine researchers may have discovered why people exposed to war are at increased risk to develop chronic problems like heart disease years later. And the culprit that links the two is surprising.

Beginning in the mid-2000s, WSU researchers interviewed a random sample of 145 American immigrants who left Iraq before the 1991 Gulf War, and 205 who fled Iraq after the Gulf War began. All were residing in metropolitan Detroit at the time of the study. Study subjects were asked about socio-demographics, pre-migration trauma, how they rated their current health, physician-diagnosed and physician-treated obstructive sleep apnea, somatic disorders and psychosomatic disorders.

Those who left Iraq after the war began and suffered from mental disorders such as post-traumatic stress disorder (PTSD) and depression, and self-rated their physical health as worse than their actual health, were 43 times more likely than pre-Gulf War immigrants to report obstructive sleep apnea (30.2 percent versus 0.7 percent) and later develop major chronic health issues such as cardiovascular disease.

"I was surprised, but we had a specific theory we wanted to test. Changes in the stress system would contribute to sleep apnea. What happens? Maybe it's the stress that leads to this fractured sleep," said Bengt Arnetz, M.D., Ph.D., M.P.H., School of Medicine professor of occupational and environmental health, deputy director of the Institute of Environmental Health Sciences at Wayne State, and the study's principal investigator and first author. "No one had explored this possible link before, although basic research suggests it as plausible."

The obstructive sleep apnea and chronic disease link has been observed among many trauma-exposed populations, including refugees, Arnetz said.

http://www.sciencedaily.com/releases/2012/10/121015131817.htm

Police Need Sleep for Health, Performance

July 18, 2012 —

Science Daily/University of Iowa

Forget bad guys and gunfire: Being a police officer can be hazardous to your health in other ways.’

Researchers at the University of Iowa have found that police officers who sleep fewer than six hours per night are more susceptible to chronic fatigue and health problems, such as being overweight or obese, and contracting diabetes or heart disease. The study found that officers working the evening or night shifts were 14 times more likely to get less restful sleep than day-shift officers, and also were subjected to more back-to-back shifts, exacerbating their sleep deficit.

The study is the first peer-reviewed look at differences in duration and quality of sleep in the context of shift work and health risks in the police force, the authors noted.

"This study further confirmed the impact of shift work on law enforcement officers and the importance of sleep as a modifiable risk factor for police," wrote Sandra Ramey, assistant professor in the College of Nursing at the UI and the lead author on the paper published in Workplace Health & Safety. "The good news is this is correctable. There are approaches we can take to break the cascade of poor sleep for police officers."

The research is important because getting fewer than six hours of sleep could affect officers' ability to do their jobs, which could affect public safety. It also boosts the risk for health problems, which could affect staffing and could lead to higher health costs borne by taxpayers.

The researchers recommend putting practices in place to ensure officers get proper sleep. For example, 83 percent of police on the evening or night shift reported having to report to duty early the next morning at least occasionally. One idea from the UI team is to change the morning time that evening or night-shift officers may need to appear in court, to ensure that they get full rest. They also recommend that law enforcement and nurses partner more closely, to encourage officers to get 7-8 hours of sleep per night.

While officers working the evening or night shifts were more likely to get fewer than six hours of sleep, the researchers also found that police who slept fewer than six hours were twice as likely to sleep poorly. That finding is important, because poor sleep can lead to "vital exhaustion," or chronic fatigue, the authors noted, which can trigger additional health problems.

The UI study builds on other studies that show a possible link between sleep deprivation and ill health and chronic fatigue in police officers. "This finding is supported by other studies that suggested poor sleep and short sleep (with resultant fatigue) may be related to psychological stress," they wrote.

Somewhat surprisingly, the researchers did not find a strong tie between lack of sleep and the onset of health complications, although they said a larger statistical sample may be needed to more fully understand the relationship.

http://www.sciencedaily.com/releases/2012/07/120718122734.htm

Sleep Deprivation May Reduce Risk of PTSD

July 18, 2012 —

Science Daily/American Associates, Ben-Gurion University of the Negev

Sleep deprivation in the first few hours after exposure to a significantly stressful threat actually reduces the risk of Post-Traumatic Stress Disorder (PTSD), according to a study by researchers from Ben-Gurion University of the Negev (BGU) and Tel Aviv University.

The new study was published in the international scientific journal, Neuropsychopharmacology. It revealed in a series of experiments that sleep deprivation of approximately six hours immediately after exposure to a traumatic event reduces the development of post trauma-like behavioral responses. As a result, sleep deprivation the first hours after stress exposure might represent a simple, yet effective, intervention for PTSD.

"Often those close to someone exposed to a traumatic event, including medical teams, seek to relieve the distress and assume that it would be best if they could rest and "sleep on it," says Prof. Cohen. "Since memory is a significant component in the development of post-traumatic symptoms, we decided to examine the various effects of sleep deprivation immediately after exposure to trauma."

http://www.sciencedaily.com/releases/2012/07/120718131750.htm

Sleep Disorders Common Among Police Officers

December 23, 2011

Science Daily/JAMA and Archives Journals

A survey of police officers indicated that about 40 percent have a sleep disorder, which was associated with an increased risk of adverse health, safety and performance outcomes, according to a study in the December 21 issue of JAMA.

Sleep disorders, such as obstructive sleep apnea, insomnia, and shift work disorder, affect 50 to 70 million U.S. residents. Most are undiagnosed and remain untreated. "Police officers frequently work extended shifts and long work weeks, which in other occupations are associated with increased risk of errors, unintended injuries, and motor vehicle crashes. According to data through the year 2003, more officers are killed by unintended adverse events than during the commission of felonies. It has been hypothesized that fatigue- likely due to reduced duration and quality of sleep and untreated sleep disorders-may play an important role in police officer unintentional injuries and fatalities. To date, the effect of sleep disorders on police officer health, safety, and performance has not been systematically investigated," the authors write.

The researchers also found that 28.5 percent of participants had screening scores that indicated that they experienced excessive sleepiness. Of the survey respondents, 45.9 percent reported having nodded off or fallen asleep while driving; 56.9 percent of these reported falling asleep while driving at least 1 to 2 times a month; and 307 (13.5 percent, representing 6.2 percent of the total group) reported falling asleep while driving at least 1 to 2 times a week.

Compared to those who screened negative, participants who screened positive for any sleep disorder were more likely to report making important administrative errors; falling asleep while driving; making errors or committing safety violations due to fatigue; having uncontrolled anger toward a citizen or suspect; incurring citizen complaints; having absenteeism; or falling asleep during meetings.

"In conclusion, a large proportion of police officers in our sample showed a positive sleep disorder screening result, which was associated with adverse health, safety, and performance outcomes. Further research is needed to determine whether sleep disorder prevention, screening, and treatment programs in occupational settings will reduce these risks," the authors write.

http://www.sciencedaily.com/releases/2011/12/111220172618.htm

Dreaming Takes the Sting out of Painful Memories

Nov. 27, 2011 —

Science Daily/University of California - Berkeley

They say time heals all wounds, and new research from the University of California, Berkeley, indicates that time spent in dream sleep can help us overcome painful ordeals.

UC Berkeley researchers have found that during the dream phase of sleep, also known as REM sleep, our stress chemistry shuts down and the brain processes emotional experiences and takes the edge off difficult memories.

The findings offer a compelling explanation for why people with post-traumatic stress disorder (PTSD), such as war veterans, have a hard time recovering from distressing experiences and suffer reoccurring nightmares. They also offer clues into why we dream.

"The dream stage of sleep, based on its unique neurochemical composition, provides us with a form of overnight therapy, a soothing balm that removes the sharp edges from the prior day's emotional experiences," said Matthew Walker, associate professor of psychology and neuroscience at UC Berkeley and senior author of the study to be published on Nov. 23, in the journal Current Biology.

For people with PTSD, Walker said, this overnight therapy may not be working effectively, so when a "flashback is triggered by, say, a car backfiring, they relive the whole visceral experience once again because the emotion has not been properly stripped away from the memory during sleep."

The results offer some of the first insights into the emotional function of Rapid Eye Movement (REM) sleep, which typically takes up 20 percent of a healthy human's sleeping hours. Previous brain studies indicate that sleep patterns are disrupted in people with mood disorders such as PTSD and depression.

While humans spend one-third of their lives sleeping, there is no scientific consensus on the function of sleep. However, Walker and his research team have unlocked many of these mysteries linking sleep to learning, memory and mood regulation. The latest study shows the importance of the REM dream state.

"During REM sleep, memories are being reactivated, put in perspective and connected and integrated, but in a state where stress neurochemicals are beneficially suppressed," said Els van der Helm, a doctoral student in psychology at UC Berkeley and lead author of the study.

"We know that during REM sleep there is a sharp decrease in levels of norepinephrine, a brain chemical associated with stress," Walker said. "By reprocessing previous emotional experiences in this neuro-chemically safe environment of low norepinephrine during REM sleep, we wake up the next day, and those experiences have been softened in their emotional strength. We feel better about them, we feel we can cope."

Walker said he was tipped off to the possible beneficial effects of REM sleep on PTSD patients when a physician at a U.S. Department of Veterans Affairs hospital in the Seattle area told him of a blood pressure drug that was inadvertently preventing reoccurring nightmares in PTSD patients.

It turns out that the generic blood pressure drug had a side effect of suppressing norepinephrine in the brain, thereby creating a more stress-free brain during REM, reducing nightmares and promoting a better quality of sleep. This suggested a link between PTSD and REM sleep, Walker said.

"This study can help explain the mysteries of why these medications help some PTSD patients and their symptoms as well as their sleep," Walker said. "It may also unlock new treatment avenues regarding sleep and mental illness."

http://www.sciencedaily.com/releases/2011/11/111123133346.htm

Current training programs may not prepare firefighters to combat stress

November 2, 2011

Science Daily/Human Factors and Ergonomics Society

Current training programs may not effectively prepare firefighters for the range of scenarios they are likely to encounter, according to human factors/ergonomics researchers.

Firefighters must make complex decisions and predictions and must perform extreme tasks at a moment's notice. Failure to keep a level head in the face of a dangerous situation may result in disastrous consequences. An effective training program that prepares firefighters to handle unanticipated changes may be the key to maintaining low stress levels and preventing stress-related health issues.

The most common form of training exposes firefighters to one or a very small set of live-fire scenarios designed to reduce stress and encourage calm decision-making skills. But repeated exposure to the same scenario may fail to adequately prepare firefighters for changing situations, as lessons learned in that scenario may not transfer to a different scenario.

"Repeated high levels of stress are associated with a host of health problems," Baumann said. "In firefighters specifically, the stress has been linked to increased risk of alcohol abuse, cardiovascular disease, and posttraumatic stress disorder. Finding a way to reduce the stress levels is a worthy goal."

http://www.sciencedaily.com/releases/2011/11/111102190358.htm