Sleep Structure in Refugees Diagnosed With PTSD
2. Project period:
31.01.2018 – 31.06.2019
Mia Beicher Ansbjerg, Pre-graduate Researcher and Medical Student
4. Supervisors and collaborative partners:
- Principal supervisor: Associate Professor Jessica Carlsson Lohmann, CTP
- Co-supervisor: MD Hinuga Sandal, CTP
- Co-supervisor: Professor Poul Jennum, Danish Center for Sleep Medicine
- Co-supervisor: Lone Baandrup, Mental Health Center Glostrup
Post-Traumatic Stress Disorder (PTSD) is the clinical manifestation of traumatic events and is often
associated with flash backs, avoidance behaviour, hyperarousal and sleep disturbances, the latter being
highly prevalent and causing many obstacles for patients in their everyday life. Sleep disturbances, if left
untreated, may persist or even worsen symptoms of PTSD despite a multidisciplinary treatment effort,
constituting a risk for poor outcome of psychiatric treatment. It has been argued that effective treatment
of sleep disturbances may accelerate recovery in PTSD.
The aim of this study is to examine sleep structure in refugees with PTSD enrolled in treatment programs at
the Competence Centre for Transcultural Psychiatry (CTP).
By using polysomnographic measurements, the following hypotheses are tested:
- Sleep structure and sleep architecture in refugees diagnosed with PTSD differ from healthy
- Refugees diagnosed with PTSD has increased dream activity compared to healthy controls, which
may be associated to increased incidence of REM Sleep Without Atonia (RSWA) and REM Sleep
Behavior Disorder (RBD).
- Refugees diagnosed with PTSD has increased incidence of Sleep Apnea and Periodic Limp
Movements (PLMs) compared to healthy controls.
The study is a cross-sectional study performed at CTP in collaboration with Danish Center for Sleep
7.1 Number of participants (N):
20 refugees diagnosed with PTSD and 20 healthy controls.
Trauma-affected refugees or family reunited with a refugee fulfilling the criteria for
Posttraumatic Stress Disorder and referred for treatment at CTP.
7.3 Description of data and data collection:
The study will include patients from May 2018 to February 2019.
All patients referred to CTP will be invited to an initial consultation with a doctor. During this
consultation a diagnostic assessment will be performed and the clinical history will be obtained.
Patients who give informed consent will be invited to participate in the sleep project and have sleep
measurements performed by polysomnography. Furthermore self-administered questionnaires and
semi-structured interviews will be used to collect information on mental health, sleep quality, sleep
length and nightmares. Each patient will be equipped with PSG equipment to do measurements at home for one night (12
hours). Healthy control subjects will fill out the same CTP standard ratings and have the same
diagnostic assessment and PSG measurement.
7.4 Application/acceptance from the Danish Data Protection Agency, the National Committee on
Health Research Ethics:
The differences between the two groups will be analyzed using parametric or non-parametric statistical
tests. The study is a proof-of-concept study and therefore a power calculation has not been performed.
Due to the small sample size the data obtained might not be statistically significant which will be taken
into consideration when analyzing the data.
8. Expected results:
This study will be the first to record the biophysiological changes that occur during sleep in refugees with
PTSD. This will contribute with new and potentially crucial knowledge of sleep disturbances in these
patients. The study is expected to be hypothesis generating in relation to what future studies should focus
9. Dissemination of results
The results will be presented at national and international conferences, in other settings relevant to
professionals working with trauma-affected refugees and in peer-reviewed scientific journals.
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Available from: http://www.ncbi.nlm.nih.gov/pubmed/18424196