Sleep and wellbeing study
Research type
Research Study
Full title
Relationship between sleep the first night and week after trauma and subsequent intrusive memories: a prospective study from the emergency department
IRAS ID
195832
Contact name
Lalitha Iyadurai
Contact email
Sponsor organisation
Clinical Trials and Research Governance, University of Oxford
Duration of Study in the UK
0 years, 9 months, 31 days
Research summary
Most people will experience a psychologically traumatic event, such as a life-threatening accident, at some point in their life. In the initial days after such an event, it is common to be haunted by intrusive memories: image-based memories of the event that spring to mind unbidden. Intrusive memories can be distressing in their own right, but are also a hallmark symptom of post-traumatic stress disorder (PTSD).
Sleep is important for many functions involved in how we perceive, respond to and remember events, including stressful/traumatic events. Studies with patients who have experienced traumatic events indicate that sleep disturbances in the first weeks post-trauma are associated with later PTSD symptoms. However, in a previous study with healthy volunteers exposed to experimental trauma (film footage), those who were sleep-deprived in the first night, compared to those who slept, had fewer intrusive memories in the following week. This raises the question of how sleep in the first night, but also the first week, after real-life trauma is related to subsequent intrusive memories and PTSD symptoms.
The current study is an observational study of patients recruited from a hospital emergency department after a traumatic event. After completing brief baseline questionnaires in the emergency department, participants will be asked to fill in a daily diary of their sleep and intrusive memories over the following week. Post-traumatic stress symptoms, anxiety and depression will be assessed by post/online at one week and two months. Participants will be telephoned after two months to complete an interview to assess PTSD symptoms and an optional feedback interview.
This clinical study will be the first to assess the relationship between sleep in the first night and week, intrusive memories and mental wellbeing after real-life trauma. Findings may have implications for developing simple sleep-based preventive treatments after trauma in the future.
Summary of results
After a psychologically traumatic event, such as a life-threatening accident, it is common to be haunted by intrusive memories, such as mental pictures, of the event that spring to mind unbidden. Disrupted sleep after such an event can be associated with later post-traumatic stress disorder (PTSD) symptoms, which include intrusive memories. In this study, we were interested in how sleep on the first night after a traumatic event is linked to intrusive memories in the first week as well as PTSD symptoms 2 months later. 87 people who were waiting in a hospital emergency department after a traumatic event (such as a road traffic accident or serious fall) wore a watch to record their sleep and kept a diary about their sleep and intrusive memories over the next week, and were asked about PTSD symptoms after 2 months. The results suggested that either “too little” or “too much”sleep on the first night was associated with having more intrusive memories in the first week. People who described symptoms suggesting they had PTSD at 2 months had about three times as many intrusive memories in the first week than those who did not. These results suggest that tracking sleep and intrusive memories in the first week after a traumatic event may help to identify people who are more vulnerable to later difficulties.We would like to thank the study participants and the healthcare staff at the John Radcliffe Hospital emergency department who helped with this study. This research was carried out at the University of Oxford with funding from the Wellcome Trust (Strategic Award 098461/Z/12/Z). The full published study can be found here: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fclick.pstmrk.it%2F3ts%2Facademic.oup.com%252Fsleep%252Farticle%252F43%252F8%252Fzsaa033%252F5781164.%2FNBTI%2FGCe6AQ%2FAQ%2Ffb595946-21ec-439e-b7c3-22c09e163f6c%2F2%2FftiGY-J4Jw&data=05%7C02%7Cderby.rec%40hra.nhs.uk%7C4c8e554e888f4b0990de08dd213670ca%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638703239875691344%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=SljdoGyGsvEYk%2BcA9EbU%2BPTS7gLm3Ucs8w2vlfOqcm8%3D&reserved=0
REC name
East Midlands - Derby Research Ethics Committee
REC reference
16/EM/0326
Date of REC Opinion
30 Sep 2016
REC opinion
Further Information Favourable Opinion