A 39-year-old man with no significant medical history sleepwalks, sleep-talks, and snores loudly.  He kicks and punches the air during the night — and sometimes hits at his wife, one time bruising her face. What’s the diagnosis?

Wait, one more thing: all this started after he returned from a 12-month deployment during the Iraq War in 2007. Now, what’s the diagnosis?

It’s not any sleep disorder that’s currently in the books, according to one military sleep doctor. Col. Vincent Mysliwiec, a sleep-medicine specialist for the U.S. Army, thinks that cases like the one described comprise a new syndrome, which he calls Trauma-Associated Sleep Disorder, or TSD.

“This disorder has some similarities with both Post-Traumatic Stress Disorder(PTSD) and REM Behavior Disorder (RBD), in which people act out their dreams, but it does not respond to the characteristic treatment for either of those,” he told The Huffington Post. “Most importantly, it’s observed among young veterans who were deployed in active combat.”

Mysliwiec, who is based at Brooke Army Medical Center in San Antonio, began observing hard-to-classify sleep disturbances among veterans returning from Operation Iraqi Freedom in Iraq and Operation Enduring Freedom in Afghanistan around 2008. He outlined the diagnostic criteria for TSD in a 2014 article in the Journal of Clinical Sleep Medicine.

Most TSD sufferers don’t experience daytime symptoms, like flashbacks, which are a hallmark of PTSD. The drug Clonazepam, which treats PTSD, is ineffective on TSD symptoms. And unlike in RBD, the nightmares in this syndrome are usually replays of a traumatic combat experience, rather than generalized scary dreams.

Read More: HP

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