Study Title: Sleep and emotion processing in adolescent Post-traumatic stress disorder
Principal Investigators: Stephanie Jones, PhD and Ryan Herringa, MD, PhD
Project Summary
Although nearly all affective disorders are associated with sleep pathology, PTSD is singularly conceptualized as one in
which functionally impairing symptoms, including trauma re-experiencing and hyperarousal, are present across the 24-
hour period—during both wake and sleep. As such, sleep pathology has been reconceptualized from a highly comorbid
symptom with little mechanistic value to a function that is fundamentally involved in the development, maintenance,
and severity of the disorder.
Remarkably, sleep research in youth with PTSD has relied almost exclusively on subjective assessments of sleep, which
afford no information about the sleeping brain. This gap is particularly relevant given the overlap between the
functional impairments, both neural and behavioral, associated with PTSD and those associated with poor quality
sleep.
In this proposal, we will explore sleep’s relationship to emotion processing and daily affect in 165 adolescents between
15-18 years spilt into 3 groups: PTSD, TEC (trauma-exposed comparison) and TD (typically developing). We will use
advanced sleep assessment methodologies including: (1) high-density EEG (256 channels) in the laboratory to explore
the regional distribution of sleep before and after an emotional learning task and; (2) a sleep-wearable EEG recording
headband, SmartSleep, to record sleep in the ecologically relevant home-environment, longitudinally, (14 days) and
explore its relationship to daily measures of affect and symptom severity. Finally, to determine whether the deepest
sleep (e.g. slow-wave activity (SWA); EEG frequency 1-4 hertz) of non-rapid eye-movement sleep (NREM)) can be
reliably increased over time in youth, during one 5-day period of sleep recording, we will increase SWA using
SmartSleep’s acoustic enhancement algorithms. These algorithms represent the first validated, non-pharmacological
method available for enhancing slow-waves.
Our long-term goal is to understand the role sleep plays in the maintenance and progression of adolescent PTSD. We
expect our results will have a significant impact on our understanding of sleep pathophysiology in adolescent PTSD and
to lay groundwork for larger clinical trials to test novel sleep neuromodulatory interventions.