Sleep Disturbances in Posttraumatic Stress Disorder
Authors: Germain Anne 
Published: October 2009

CME Educational Objectives

1.
Classify sleep disturbances as an important treatment target in adults with PTSD.

2.
Identify frequent sleep disturbances associated with PTSD.

3.
Recognize effective pharmacological and behavioral treatments of sleep disturbances in PTSD.

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Instructions

1.
Review the stated learning objectives of the CME articles and determine if these objectives match your individual learning needs.

2.
Read the articles carefully. Do not neglect the tables and other illustrative materials, as they have been selected to enhance your knowledge and understanding.

3.
The following quiz questions have been designed to provide a useful link between the CME articles in the issue and your everyday practice. Read each question, choose the correct answer, and record your answer on the CME REGISTRATION FORM at the end of the quiz. Retain a copy of your answers so that they can be compared with the correct answers should you choose to request them.

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CME Accreditation
This CME activity is primarily targeted to patient-caring physicians specializing in psychiatry. There are no specific background requirements for participants taking this activity. Learning objectives are found at the beginning of each CME article.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Vindico Medical Education and PSYCHIATRIC ANNALS. Vindico Medical Education is accredited by the ACCME to provide continuing medical education for physicians.

Vindico Medical Education designates this educational activity for a maximum of 3
AMA PRA Category 1 Credits™
. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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relevant financial relationship
if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears at the beginning of each CME-accredited article in this issue.

Unlabeled and Investigational Usage
The audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage.

How to Obtain CME Credits by Reading this Issue

This CME activity is primarily targeted to patient-caring physicians specializing in psychiatry. Physicians can receive
AMA PRA Category 1 Credits™
by reading the CME articles in PSYCHIATRIC ANNALS and successfully completing the quiz at the end of the articles. Complete instructions are given subsequently. Educational objectives are found at the beginning of each CME article.

CME Accreditation
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Vindico Medical Education and PSYCHIATRIC ANNALS. Vindico Medical Education is accredited by the ACCME to provide continuing medical education for physicians.

Vindico Medical Education designates this educational activity for a maximum of 3
AMA PRA Category 1 Credits™
. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Full Disclosure Policy

In accordance with the Accreditation Council for Continuing Medical Education's Standards for Commercial Support, all CME providers are required to disclose to the activity audience the
relevant financial relationships
of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears at the beginning of each CME-accredited article in this issue.

Unlabeled and Investigational Usage
The audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage.

Educational Objectives Overview
Posttraumatic stress disorder (PTSD) results from traumatic experiences that overwhelm one's capacity to cope coupled with a propensity to develop the disorder. The harmonics from acute or chronic trauma disrupt and dysregulate multiple neuronal circuits with hyperreactivity to stimuli, hypervigilance, anxiety, insomnia, nightmares, persistent unwanted ruminations, and mood symptoms. Limited evidence exists for effective treatments, and multimodal pragmatic approaches may be reasonable until further treatments are developed.

Table of Contents

326
The Epidemiology of Posttraumatic Stress Disorder

Jennifer Johnson, MPH; Andrea Maxwell, BS; and Sandro Galea, MD, DrPH

335
Sleep Disturbances in Posttraumatic Stress Disorder

Anne Germain, MD

342
Pharmacotherapy of PTSD: Current Status and Controversies

Gregory Sullivan MD; and Yuval Neria, PhD

348
A Guide to the Literature on Psychotherapy for PTSD

Jessica L. Hamblen, PhD; Paula P. Schnurr, PHD; Anna Rosenberg, MA; and Afsoon Eftekhari, PhD

Responsibility for Statements

All opinions expressed by authors and quoted sources are their own and do not necessarily reflect the opinions of the editors, publishers, or editorial boards of
Psychiatric Annals
or its employees, Vindico Medical Education or its employees, or the University of New Mexico. The acceptance of advertising in no way implies endorsement by the editors, publishers, or editorial boards of
Psychiatric Annals
.

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Psychiatric Annals
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Psychiatric Annals
. Neither
Psychiatric Annals
, Vindico Medical Education, nor the faculty endorse or recommend any techniques, commercial products, or manufacturers. The faculty/authors may discuss the use of materials and/or products that have not yet been approved by the U.S. Food and Drug Administration. Articles are intended for informational purposes only and should not be used as the basis of patient treatment. All readers and continuing education participants should verify all information before treating patients or utilizing any product.

Copyright © 2009
by SLACK Incorporated. All rights reserved. No part of this publication may be reproduced without prior written consent of the publisher.