The sleep lab at Western Psychiatric Institute and Clinic of UPMC looks like an extended stay hotel suite. There’s a small kitchen, sitting room and a nice TV. It’s clean and sparse, dark and quiet.
Except for going to bed at a set time, research volunteers basically get to do whatever they want.
“Oftentimes people see it as almost taking a break… kind of checking out for a little bit,” said University of Pittsburgh sleep researcher Anne Germain.
Germain is studying the sleep of veterans and active duty service members. Between 11 and 20 percent of Iraq and Afghanistan war veterans have Post Traumatic Stress Disorder and evidence suggests a strong link between poor sleep and the disorder.
PTSD can develop after frightening or distressing events, such a natural disaster, assault, or combat. Irregular sleep, which is typical for enlisted service members, may predispose some people, but little is understood about its underlying physiological process.
In a nearby office, Germain and her team monitor data that’s collected from special sensors participants wear at night. A computer screen displays a circle representing the brain, red and blue waves undulate over the image like wax bubbles in a lava lamp.
“The red hot spot is where there’s more activity and the blue is where there’s less activity,” said Germain, pointing to the screen. “Look how quickly it changes from one second to the other.”
These swirls represent the sleep patterns of research volunteer John Lawson, 38, an Iraq War veteran. Lawson says in his opinion, everyone who returns from a theater of war has some degree of PTSD.
“You’ll never forget what you went through,” he said. “You’ll never completely brain dump that. But the intensity of that gets less and less and less as time goes on.”
It’s normal to be distressed after a harrowing experience, so clinicians don’t make a diagnosis until at least 30 days after a traumatic event.
Most people get better. But some get stuck, they’re constantly on edge, might act irritable or hostile, have flashbacks, nightmares, avoid crowds, feel depressed and they often have trouble sleeping.
“It would not be uncommon for a person to come into my office and say at most they’re getting four hours of broken sleep a night,” said psychologist Kathleen DeNardi, who treats PTSD patients at the Pittsburgh VA hospital. “Imagine the Vietnam veterans that I’m treating and that their sleep has been like this for 50 years.”
Pitt’s Anne Germain hypothesizes that something happens during sleep that helps people recover after trauma, but for those with PTSD, this healing sleep process fails.
Germain said Lawson is a good sleeper, which makes sense, as he doesn’t have PTSD. So monitoring him could help her figure out what restorative sleep looks like in the brain.
“Then we can use this information to say, ‘Can we stimulate that while people are sleeping?’ Could we have different techniques that could actually induce and create this pattern?” said Germain.
Both Germain and VA psychologist DeNardi says current PTSD treatments are pretty good. Therapies include helping patients change how they think and feel about trauma, and also learning to confront and work through bad memories.
But poor sleep might make these interventions less effective. So figuring out why patients aren’t getting proper rest could speed up recovery.
That’s welcomed news to Lawson, who said PTSD is almost like a “plague” among post-9/11 vets.
“If this turns out to be the one thing that we figure out, that ‘Gosh, you just need better sleep,’ you know, it will help,” he said. “It may not ever cure it. But if it gets it to that point where the veterans is able to cope better, then I think that’s a win.”
One day, sleep researchers say they might even learn enough about the brain and PTSD to prevent the diagnosis in the first place.
WESA receives funding from the University of Pittsburgh and UPMC.
WESA’s Bridges to Health covers the well-being of Pennsylvanians and is funded by the Jewish Healthcare Foundation.