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ADVANCE Perspective: Nurses

PTSD & Nightmares: Hope in Sight

Published January 23, 2012 7:15 AM by Linda Jones

There are many theories about why we dream and whether dreams are beneficial to us. Everyone has the occasional nightmare, which are usually nonsensical. But for people with post-traumatic stress disorder (PTSD) nightmares are often realistic and can be debilitating. A recent report on NPR noted that "PTSD dreams are the same real-life event played over and over again" sometimes for 20 years.

Psychology researcher Matthew Walker at the University of California, Berkeley, is investigating the role of REM, when dreams occur. During REM the levels of norepinephrine "drop out completely" and it's the only time this happens. Walker wants to know the role of this phenomenon.
According to the NPR story, "Walker's theory suggests that in people with PTSD, REM sleep is broken. The adrenaline doesn't go away like it's supposed to. The brain can't process tough memories, so it just cycles through them, again and again."

Perhaps the answer then is to chemically suppress the adrenaline.

Murray Raskind, MD, a VA psychiatrist in Seattle, has tried this. Prazosin, once used as a hypertension drug, makes people less sensitive to adrenaline, and he has given it to patients with PTSD suffering from nightmares. The veterans still have recurrent dreams, but they are not reliving horrors from the war.

Raskind told of one veteran who stopped dreaming repeatedly about seeing a friend killed in battle and instead dreams of missing an important assignment in grade school - a more typical stress dream. Raskind described it as "a healthy brain trying to work things out."

The VA is currently conducting trials with prazosin and is prescribing it to 15% of vets with PTSD who are having recurrent nightmares.

posted by Linda Jones


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