Broken dreams: Does REM sleep fragmentation make it harder to cope with stressful events?
Dr Kate Porcheret, Third Century Research Fellow.
REM sleep fragmentation is the degree to which periods of REM sleep are broken up by different sleep stages/ arousals or wake. REM sleep has received increasing attention over the years linking it to enhanced consolidation of emotional memory and the reduction of emotional reactions to those emotional memories – although the evidence for the latter is more inconsistent.
My interest in REM sleep fragmentation began when I read Eus Van Someren’s 2021 review of Brain Mechanisms for Insomnia, where he set out a new model for the development of Insomnia. I recommend reading Eus’s paper, but to paraphrase the model suggests that having restless REM sleep impairs the unique brain mechanisms that occur during REM sleep that have been linked to the regulation of emotional distress. What particularly sparked my interest was that this model could be applied to many (or possibly even all) mental health disorders. Thus, not having long enough periods of REM sleep may prevent the necessary resolution of emotional distress related to day-time events increasing the vulnerability to the development of mental health problems. This struck a chord with my research into the effect of trauma exposure on sleep. From the limited research out there, REM sleep is particularly impacted by trauma exposure as well as linked to the development of Post-Traumatic Stress Disorder (PTSD). Impaired REM sleep is also a common feature of sleep disruption in people with PTSD. REM sleep prior to trauma exposure may also impact post-traumatic reactions. In an experimental study we found that a greater REM sleep percentage and REM efficiency was associated with fewer intrusive memories (a common post-traumatic reaction) to an analogue trauma (a series of distressing film clips).
The work I am now doing in the HASTE research group at Manchester Met, aims to expand this work to look at the impact of REM sleep fragmentation on trauma and stress reactions, in particular in people working in demanding caring professions. Caring professions such a nursing, teaching, social care and social work are essential for society but also highly demanding and stressful and increasingly people in these professions are exposed to traumatic events through their work. Little is being done to support these professionals or to prepare them for the experiences they may have. I have set up the Manchester CARES cohort which includes students training for caring professions at Manchester Met with the aim to follow them once they start working in their chosen profession. I am also running an experimental study looking at the impact of REM sleep fragmentation on psycho-physiological responses to a stressor. So, the question of whether REM fragmentation makes it harder to cope with stressful events is still unanswered, but I hope my work will move us closer to finding out and I would love to hear from anyone else interested in this or looking at the impact of REM sleep fragmentation in their work.
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