Background
While it has been reported that persons with posttraumatic stress disorder (PTSD)
manifest tonic autonomic activation, the literature contains numerous counterexamples.
In revisiting the question, this study employed a novel method of mattress actigraphy
to unobtrusively estimate heart rate and respiratory sinus arrhythmia over multiple
nights of sleep in the home.
Methods
Sleep cardiac autonomic status was estimated in four diagnostic groups, posttraumatic
stress disorder, panic disorder, persons comorbid for both conditions, and control
subjects. All 59 participants were community-residing nonveterans screened for sleep
apnea and periodic leg movement disorder with polysomnography. Heart rate and respiratory
sinus arrhythmia were calculated from the kinetocardiogram signal measured via accelerometers
embedded in a mattress topper. Times in bed and asleep were also estimated. Per participant
data were obtained from a median of 12 nights.
Results
Both posttraumatic stress disorder and posttraumatic stress disorder/panic disorder
comorbid groups exhibited significantly higher heart rates and lower respiratory sinus
arrhythmia magnitudes than panic disorder participants and control subjects. Panic
disorder participants were indistinguishable from control subjects. The PTSD-only
group exhibited longer times in bed and longer times presumably asleep than the other
three groups.
Conclusions
In this study, posttraumatic stress disorder, but not panic disorder, was associated
with altered cardiac autonomic status during sleep. Among participants meeting criteria
for PTSD alone, autonomic activation co-occurred with prolongation of actigraphic
sleep.
Key Words
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Article info
Publication history
Published online: February 23, 2009
Accepted:
January 6,
2009
Received in revised form:
January 5,
2009
Received:
September 24,
2008
Identification
Copyright
Published by Elsevier Inc.
