Hope for thousands with PTSD: International research collaboration set for global impact

Sleep problems are among the top complaints of currently deployed and recently returned military personnel. These complaints are often associated with mental health symptoms, including symptoms of Post-Traumatic Stress Disorder (PTSD) and Generalised Anxiety Disorder.

It is critical that we identify the biological mechanisms related to the development, maintenance, and treatment of PTSD, so that we may better understand – and treat – those with PTSD.

Thanks to a recent Peer Reviewed Medical Research Program (PRMRP) Investigator-Initiated Research Award from the U.S. Department of Defense office of the Congressionally Directed Medical Research Programs (CDMRP), MICCN’s Professor Sean P.A. Drummond will be examining the impact of disturbances in normal sleep and circadian regulation on those mechanisms related to PTSD.

The project will leverage the combined global expertise of the VA San Diego Healthcare System and Monash University to establish whether the type of real-world REM sleep disruption experienced by military personnel increases risk of development and maintenance of PTSD.

“This will be the first study to examine this kind of REM sleep disruption, with results expected to directly translate to treatment recommendations,” Professor Drummond said.

Specifically, the team will focus on the role that common sleep and circadian rhythm disruptions in operational settings play in fear extinction and safety signal learning; the biological mechanisms known to underlie the pathophysiology of PTSD. The study will also address the role REM sleep plays in supporting fear extinction and safety signal learning; it is the first study to manipulate REM sleep in these operationally valid ways and the first to test whether restoring REM sleep pharmacologically reverses the expected negative effects of REM fragmentation.

“Fear extinction and safety signal learning represent important mechanisms in the development, maintenance, and treatment of PTSD,” Professor Drummond said. “This project holds the promise of definitively establishing that the types of REM sleep disruptions experienced by military personnel do indeed impair these mechanisms, and thus increase risk of PTSD. Our goal is to identify biological treatment targets, allowing not only improved interventions for PTSD, but also prophylactic measures aimed at preventing development of PTSD in the first place.

“If our hypotheses are supported, our findings will have implications for clinical interventions in PTSD. In particular, if REM fragmentation and circadian misalignment impair extinction and safety learning, then reducing REM disruption should help improve clinical outcomes.”

The world-first research will also examine the association between sleep disorders and traumatic brain injury, depression, and/or anxiety and suicidal behaviours.

“Our work will also support the potential for melatonin agonist treatments to augment extinction–based therapies or as a prophylactic treatment after trauma.

“Put simply, we aim to stop the adverse effects of disrupted sleep and circadian rhythms, and improve the physical and psychological health, safety, performance, and productivity of military and civilian populations,” Professor Drummond concluded.

MICCN congratulations Professor Sean P.A. Drummond on his achievement, and looks forward to hearing the outcomes of this exciting international collaboration.

For more information on his research, contact Professor Sean P.A. Drummond on t: 03 9905 3956, e: Sean.Drummond@monash.edu.

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