JOINT BASE SAN ANTONIO-LACKLAND, Texas, Oct. 12, 2022 — A team of military and civilian researchers has identified a new sleep disorder that’s been disrupting the lives of trauma survivors for decades, if not centuries.

The Journal of Clinical Sleep Medicine published the groundbreaking study, titled “Clinical and polysomnographic features of trauma associated sleep disorder,” on its site in August.

While there have been related studies, this was the largest to date and identifies trauma associated sleep disorder, or TSD, as a distinct sleep-related disorder or parasomnia, explained Air Force Lt Col (Dr.) Matthew Brock, the study’s lead author and chief of the San Antonio Market Sleep Disorders Center at Wilford Hall Ambulatory Surgical Center here.

“We believe trauma associated sleep disorder is the first adult sleep disorder and rapid eye movement (REM) parasomnia identified since Rapid Eye Movement Sleep Behavior Disorder (RBD) was identified more than 35 years ago,” he said.

The study, which spanned five years, included 40 service members who had experienced trauma, mainly from combat, and were experiencing dream enactment, which is when someone acts out dreams physically or verbally. The study comprised a clinical interview and video-recorded sleep study.

“We watched all eight hours of video on each sleep study, which is not typical,” Brock said, noting that many sleep centers record eight hours but rarely watch the video recording in its entirety. “Our key finding was that most of these patients had parasomnia behavior, or movements and vocalizations in REM sleep. This is groundbreaking because traditional wisdom is that parasomnia behavior is almost never captured in the sleep lab but is frequently cited by patients as a symptom they’re experiencing at home.”

Typically, during REM sleep, the skeletal muscle, other than eyes, diaphragm and sphincter muscles, is paralyzed to prevent people from acting out dreams. However, in some cases, the part of the brainstem responsible for paralyzing the skeletal muscle degenerates, which may result in dream enactment. This is called RBD and is commonly seen in people with neurodegenerative disorders such as Parkinson’s disease, Brock explained.

“Dream enactment behavior can include punching, kicking, defensive posturing, yelling, and movements,” Brock said. “This is disruptive, and often scary, not only for the patient, but for his or her bed partner as well.”