1175 Post Traumatic Stress Disorder Association with Elevated Electromyographic Activity During Rapid Eye Movement Sleep in Active Duty Service Members

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Abstract Introduction PTSD affects up to 31% of US combat Veterans, impacting mental and physical health. PTSD commonly results in sleep disturbances; greater symptoms associate with poorer sleep, insomnia, and nightmares. Chronic sleep disturbances contribute to neurodegeneration, often preceded by dream enactment, or REM behavior disorder (RBD). RBD involves loss of REM paralysis, or REM sleep without atonia (RSWA), identified with electromyographic (EMG) activity and appearing with greater severity in Veterans with PTSD. Standardized human scoring is laborious and lacks granularity to identify subtle atonia differences across large populations. Novel algorithms enable detailed RSWA measurements at high resolution. We hypothesized we would identify RSWA differences in SMs with PTSD (PTSD+) versus those without (PTSD-) using an open-source algorithm, RBDTetector, in standard polysomnograms. Methods We compared RSWA in 12 PTSD+ and PTSD- SMs at the Walter Reed Sleep Disorder Center. Following clinician graded sleep scoring, we used RBDtector to analyze EMG activity and sleep stages in the chin and tibialis anterior. In our initial analysis, we used a one-way ANOVA to determine if RSWA is higher in PTSD+ SM’s compared to PTSD-. Results PTSD+ SMs had significantly higher phasic (0.1 – 5.0s) bouts of chin EMG activity (p < 0.001). Further, there was increased EMG activity (p = 0.003) in PTSD+ SMs. Larger sample analysis is ongoing. Conclusion These preliminary results indicate that PTSD+ SMs exhibit greater symptoms of RSWA than PTSD- SMs. Further analysis towards our target sample size (n = 100 in each group) will support these preliminary findings. PTSD and RBD may share overlapping neuropathologic pathways, enhancing our understanding of PTSD treatment. Support (if any) This project is sponsored by the Department of Defense and the Uniformed Services University of the Health Sciences (USU). The views, information or content, and conclusions presented do not represent the official position or policy of, nor should any official endorsement be inferred on the part of, the Uniformed Services University, the Department of War, or the U.S. Government.

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