Journal
BIOLOGICAL PSYCHIATRY-COGNITIVE NEUROSCIENCE AND NEUROIMAGING
Volume 2, Issue 2, Pages 123-129Publisher
ELSEVIER
DOI: 10.1016/j.bpsc.2016.05.004
Keywords
Extinction; Fear conditioning; Fear potentiated startle; PTSD; REM sleep; Sleep deprivation
Categories
Funding
- Department of Defense [DM102425]
- National Institute of Mental Health National Research Service Award [F31MH106209]
- Veterans Affairs Center of Excellence for Stress and Mental Health
- Brain and Behavior Research Foundation (National Alliance for Research on Schizophrenia and Depression)
- Department of Defense
- University of California San Diego Clinical and Translational Research Institute
- National Institutes of Health
- Department of Defense, Navy Bureau of Medicine and Surgery
- Department of Veterans Affairs
- Johnson Johnson
- National Science Foundation
- National Health and Medical Research Council (Australia)
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BACKGROUND: Learned fear is crucial in the development and maintenance of posttraumatic stress disorder and other anxiety disorders, and extinction of learned fear is necessary for response to exposure-based treatments. In humans, research suggests that disrupted sleep impairs consolidation of extinction, though no studies have examined this experimentally using total sleep deprivation. METHODS: Seventy-one healthy control subjects underwent a paradigm to acquire conditioned fear to a visual cue. Twenty-four hours after fear conditioning, participants underwent extinction learning. Twenty-four hours after extinction learning, participants underwent extinction recall. Participants were randomized to three groups: 1) well rested throughout testing (normal sleep; n = 21); 2) 36 hours' total sleep deprivation before extinction learning (pre-extinction deprivation; n = 25); or 3) 36 hours' total sleep deprivation after extinction learning and before extinction recall (post-extinction deprivation; n = 25). The groups were compared on blink electromyography reactivity to the condition stimulus during extinction learning and recall. RESULTS: There were no differences among the three groups during extinction learning. During extinction recall, the pre-extinction deprivation group demonstrated significantly less extinction recall than the normal sleep group did. There was no significant difference between the normal sleep and post-extinction deprivation group during extinction recall. Results indicated sleep deprivation before extinction training significantly disrupts extinction recall. CONCLUSIONS: These findings suggest that 1) sleep deprivation in the immediate aftermath of trauma could be a potential contributor to posttraumatic stress disorder development and maintenance via interference with natural extinction processes and 2) management of sleep symptoms should be considered during extinction-based therapy.
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