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“How Sleep Impacts PTSD”

Presented by Karen Lansing, MFT, BCETS Cop Whisperer® Enterprise © 2015

Permission to reproduce given to the

EMDR CONFERENCE 2015

A Few Worrisome Facts...

Loosing only 3 hours of sleep is able to impair driving ability to maintain speed and road position at an = level of the .05 BAL.

20 hours of wakefulness will cause impairment = BAL of .10 (2 x’s the presumptive level of intoxication in most US States).

With Consistently Good Sleep ... The Brain Looks Like This

With a Chronic Sleep Deficit the Brain will Look Kinda Like This...

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• 1.9 x’s more likely than well rested responders to be injured on the job.”

• 2.2 x’s more likely to commit a medical error...

• They’re 3.6 x’s more likely to be involved in a safety-compromising behavior:

Contributors included protocol deviation / dropping patients / medication errors

2012 study out of Univ of Pittsburg links sleep deprivation of EMS

Responders to increased rates of Injuries and medical errors.

Patterson, Weaver et al, Association between poor sleep, fatigue and safety outcomes in EMS Providers, Prehosp Emerg Care; 2012; 16(1)86–97.

Study Examines Effects of Sleep Deprivation on Shift Work: Medical professionals are beginning to call fatigue the #1 problem in our field

By Jane Jerrard

Saturday, March 1, 2008 Issue of FireRescue

“When we are over-tired, our compassion and empathy are often the 1st to go.”

T. McCallion: Study examines Effects of Sleep Deprivation on Shift Work (http://www.jems.com/article/news/study-measures-effect-sleep-deprivation

BUT WAIT...THERE’S MORE!!!

Research has shown that while sleep loss has negative effects on three basic areas—motor performance, cognitive function, and mood—it has the strongest effect on mood and weakest on motor functions.

Graveyard Shift (2300-8:00) officers: 8%

Day (7-1700) & Swing Shift (1600-0200) officers reported a drop in their ability to easily handle minor irritation: 1%

(J.J. Pilcher, and A. Huffcutt, “Effects of Sleep Deprivation on Performance: A Meta-analysis,” Sleep, no. 19 (4): 318-326.)

Once the body is fatigued... loss of coordination, accuracy, response time, gauge of distance. If sleep doesn’t come then in an effort to gain rest the body will go into “micro-sleep mode”...

Welcome to the greatest Killer of Cops...

There’s no way to predict when a person will fall into this state.

So Far in July 2015: Vehicle related: 29 Weapon related: 18

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“Fatigue is 4 times more likely to cause workplace impairment than alcohol and other drugs.”

Ironically, chemical abuse normally is addressed immediately by management. However, the lack of sleep, probably the most common condition adversely affecting personnel performance, often is ignored.”

Spcl Agent Dennis Lindsey

Sr. Instructor, DEA Academy

And that can cause errors / failed rescue attempts that can then cause traumatic events to occur ...

“There  is  a  strong  sugges.on  that  CHRONIC  sleep  disturbance  BEFORE    a  trauma.c  event  can  increase  someone’s  risk  of  geAng  PTSD.” Germain, et al; ”Clinical correlates of poor sleep quality in PTSD,” Jrnl of Traumatic Stress Vol 17, 2004

= =

So...

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“Sleep of PTSD suffers is known to be more fragmented than normal and they appear to retain an inappropriate level of Vigilance.”

Mellman, Kumara,Kulick-Bell & Nolan, 1995 Melman, 1997

What May Cause the Disription to Sleep?

A New Description of PTSD...?

Dr. Robert Stickgold Dept. of Psychiatry, Harvard Medical School EMDR: a Putative Neurobiological Mechanism of Action Journal of Clinical Psychology, Vol. 58 (1), 61 - 75 (2002)

It’s not a memory dysfunction...It’s a break down in sleep dependent memory reprocessing

that’s normally brought on with REM sleep.

 And  What  Happens  in  REM  SLEEP?  

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Here’s a Brilliant Guy who can help explain a few things....

He  was  the  1st  since  Freud  to  ask...              Why  do  we    

Then REM Sleep Induced Reprocessing Kicks in...

REM

Trauma Based Memory

Fragmented

Fragmented Sleep Occurs

Adaptive Learning i.e. newTactics

for the future

Bringing about adaptive behaviours and change for the future. Connects up and Integrates Memories to Make Sense

Integration

(connecting dots & gaining context)

Dr. Robert Stickgold Dept. of Psychiatry, Harvard Medical School

EMDR: a Putative Neurobiological Mechanism of Action Journal of Clinical Psychology, Vol. 58 (1), 61 - 75 (2002)

Sound Familiar?

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IN CLOSING...

I’m now lobbying to rebrand PTSD As

“Post Trauamtic Sleep Disorder”