Treatment of sleep disturbances in post-traumatic stress disorder

The sleep justice study - a prospective cohort study assessing sleep as a cardiometabolic risk factor after incarceration: a protocol paper

BACKGROUND

An estimated 11 million individuals are released from U.S. jails and prisons each year. Individuals with a history of incarceration have higher rates of cardiovascular disease (CVD) events and mortality compared to the general population, especially in the weeks following release from carceral facilities. Healthy sleep, associated with cardiovascular health, is an underexplored factor in the epidemiology of CVD in this population. Incarcerated people may have unique individual, environmental, and institutional policy-level reasons for being sleep deficient. The social and physical environment within carceral facilities and post-release housing may synergistically affect sleep, creating disparities in sleep and cardiovascular health. Since carceral facilities disproportionately house poor and minoritized groups, population-specific risk factors that impact sleep may also contribute to inequities in cardiovascular outcomes.

METHODS

This study is ancillary to an ongoing prospective cohort recruiting 500 individuals with known cardiovascular risk factors within three months of release from incarceration, the Justice-Involved Individuals Cardiovascular Disease Epidemiology (JUSTICE) study. The Sleep Justice study will measure sleep health among participants at baseline and six months using three validated surveys: the Pittsburgh Sleep Quality Index (PSQI), the STOP-Bang, and the Brief Index of Sleep Control. In a subsample of 100 individuals, we will assess sleep over the course of one week using wrist actigraphy, a validated objective measure of sleep that collects data on rest-activity patterns, sleep, and ambient light levels. Using this data, we will estimate and compare sleep health and its association with CVD risk factor control in individuals recently released from carceral facilities.

DISCUSSION

The incarceration of millions of poor and minoritized groups presents an urgent need to understand how incarceration affects CVD epidemiology. This study will improve our understanding of sleep health among people released from carceral facilities and its potential relationship to CVD risk factor control. Using subjective and objective measures of sleep will allow us to identify unique targets to improve sleep health and mitigate cardiovascular risk in an otherwise understudied population.

The effectiveness of non-pharmacologic treatments compared to pharmacologic treatments in veterans with sleep disturbances: a systematic review protocol

OBJECTIVE

The objective is to determine the effectiveness of non-pharmacologic treatments compared to pharmacologic treatments in veterans with sleep disturbances.

INTRODUCTION

Sleep disturbances in veterans are a common occurrence. If left untreated, these individuals are susceptible not only to accidents and injuries but long-term psychiatric and/or cardiovascular complications.

INCLUSION CRITERIA

This review will consider studies of veterans, aged 18 and over, with a diagnosis of sleep disturbances. This study will exclude patients with psychotic disorders, obstructive sleep apnea, or other medical illnesses causing disrupted sleep.

METHODS

This review will use the JBI methodology for evidence of effectiveness. The search will be limited to studies published in English after 1970. The databases to be searched include MEDLINE (PubMed), CINAHL (EBSCO), Embase (Elsevier), Scopus (Elsevier), and PsycINFO (EBSCO). The trial registers to be searched include US National Library of Medicine (ClinicalTrials.gov) and Cochrane Library. The search for unpublished studies will include ProQuest Dissertations and Theses, MedNar, and WorldWideScience. Eligible studies will undergo critical appraisal and data extraction by two independent reviewers using standardized critical appraisal instruments and a data extraction tool from JBI. Studies will be pooled in statistical meta-analysis when possible. When statistical pooling is not possible, the findings will be presented in narrative form with tables and figures.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO (CRD42019140804).

Current understanding of fear learning and memory in humans and animal models and the value of a linguistic approach for analyzing fear learning and memory in humans

Fear is an emotion that serves as a driving factor in how organisms move through the world. In this review, we discuss the current understandings of the subjective experience of fear and the related biological processes involved in fear learning and memory. We first provide an overview of fear learning and memory in humans and animal models, encompassing the neurocircuitry and molecular mechanisms, the influence of genetic and environmental factors, and how fear learning paradigms have contributed to treatments for fear-related disorders, such as posttraumatic stress disorder. Current treatments as well as novel strategies, such as targeting the perisynaptic environment and use of virtual reality, are addressed. We review research on the subjective experience of fear and the role of autobiographical memory in fear-related disorders. We also discuss the gaps in our understanding of fear learning and memory, and the degree of consensus in the field. Lastly, the development of linguistic tools for assessments and treatment of fear learning and memory disorders is discussed.