A retrospective study of 1,078 adults with PTSD treated at a sleep center documented round-the-clock sleep/wake disturbances. The higher their PTSD symptom scores, the more apt they were to report bedtime worries about losing sleep, racing thoughts, watching the clock, and restless legs syndrome. The same people reported trouble falling asleep, night waking, nightmares, periodic limb movements, and poor sleep. In the daytime, they had more trouble with memory and concentration, felt sleepier and more fatigued, and reported lower quality of life than those with lower PTSD scores. The severity of their symptoms was correlated with sleep factors that promote excess arousal, Barry Krakow, M.D., and colleagues at Maimonides Sleep Arts and Sciences in Albuquerque, N.M., reported at the annual meeting of the Associated Professional Sleep Societies in June. Changes in the brain during sleep in people with PTSD may maintain or increase activity in arousal-promoting brain centers and reduce activity in sleep-promoting centers, Anne Germain, Ph.D., an associate professor of psychiatry at the University of Pittsburgh School of Medicine, told Psychiatric News.
More than 150 years ago, Elias Howe invented a refined lock stitch sewing machine that would revolutionize manufacturing, but he hit a snag. "He was stuck on the needle," says Deirdre Barrett, psychology professor at Harvard Medical School. He couldn't get it through fabric and bring thread back again. Then he had a frightening dream of island savages threatening to spear him if he didn't finish the design. He awoke excited, because their spear tips had holes — like needles with eyes in the point — and the solution to his problem. Our life is influenced by dreams whether we like it or not, says Barrett, author of "The Committee of Sleep." But she and other experts say dreams can be harnessed to solve problems (especially when we have to think visually or out of the box) and increase our emotional intelligence. Our sleeping minds took the spotlight this summer as the film "Inception" grossed $283 million at the box office and asked us to wonder if someone else could change our behavior by entering our dreams. Most of us think of dreams as stories that help process waking life, says Dr. Barry Krakow, medical director of Maimonides Sleep Arts & Sciences in Albuquerque. While science can't say for sure, Krakow, author of "Sound Sleep, Sound Mind: 7 Keys to Sleeping Through the Night," says he believes that's true. "Life is multidimensional," Krakow says. It would be impossible to consciously understand all of it — work, family, society — as a single unit. But "dreams have that capacity to integrate thoughts and images." And dreams often do more than merely echo waking life, Barrett says. She points to past studies showing that, while bad dreams often follow bad days, it's frequently the other way around. Our days often mirror dreams from the night before. "I think dreams do set the emotional tone for the day," says Thomas McKenna, who does dream therapy at Life Change Psychotherapy Institute in Albuquerque. "Sometimes it's more subtle,"
How Chronic Stress Screws Up Your System It should be simple: You are tired and it's bedtime, so you drift away within minutes of putting head to pillow. But when you're stressed, things go haywire, and the exact opposite happens instead. Being even a little anxious can make your muscles tense, prompt your body to release the stress hormones cortisol and adrenaline, and elevate your heart rate.
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Sound Sleep, Sound Mind with Barry Krakow, MD
Barry Krakow, MD is a board certified internist and sleep disorders specialist who has spent over 30 years in medicine in the fields of internal, emergency, addiction and sleep medicine. He has conducted more than two decades of research in the treatment of chronic nightmares and disturbing dreams at the University of New Mexico School of Medicine (1988-1999) and the Sleep & Human Health Institute (2000-current).
Dr. Krakow graduated magna cum laude from the University of Maryland School of Medicine. He was residency trained and board certified in internal medicine and also has ten years of clinical work in emergency medicine. He is a member of the American Academy of Sleep Medicine and the Sleep Research Society and is the former medical director of University Hospital Sleep Disorders Center.
Dr. Krakow has published two books, Insomnia Cures and his most recent, Sound Sleep, Sound Mind, is the first book of its kind to focus on mental, emotional and physical causes to sleep disturbances. Dr. Krakow and his wife, Jessica Kohr-Krakow have also published Turning Nightmares into Dreams, an innovated self-help, audio series and workbook to eliminate bad dreams.
Patients With Treatment-Resistant Insomnia Taking Nightly Prescription Medications for Sleep: A Retrospective Assessment of Diagnostic and Treatment Variables
Barry Krakow, MD; Victor A. Ulibarri, BS; and Edward A. Romero, BS
Background: Some chronic insomnia patients who take nightly prescription medication achieve less than optimal results. The US Food and Drug Administration (FDA) and the American Academy of Sleep Medicine (AASM) recommend reevaluation of this type of patient to assess for potential psychiatric or medical causes to explain this “failure for insomnia to remit.”