When time stands still: an integrative review on the role of chronodisruption in posttraumatic stress disorder

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Item Type:	Review
Title:	When time stands still: an integrative review on the role of chronodisruption in posttraumatic stress disorder
Creators Name:	Agorastos, A., Kellner, M., Baker, D.G. and Otte, C.
Abstract:	Purpose of review: The human circadian system creates and maintains cellular and systemic rhythmicity essential to homeostasis. Loss of circadian rhythmicity fundamentally affects the neuroendocrine, immune and autonomic system, similar to chronic stress and, thus, may play a central role in the development of stress-related disorders. This article focuses on the role of circadian misalignment in the pathophysiology of posttraumatic stress disorder (PTSD). Recent findings: Sleep disruption is a core feature of PTSD supporting the important supraordinate pathophysiological role of circadian system in PTSD. Furthermore, direct and indirect human and animal PTSD research suggests circadian system linked neuroendocrine, immune, metabolic and autonomic dysregulation with blunted diurnal rhythms, specific sleep pattern pathologies and cognitive deficits, as well as endocannabinoid and neuropeptide Y system alterations and altered circadian gene expression, linking circadian misalignment to PTSD pathophysiology. Summary: PTSD development is associated with chronodisruption findings. Evaluation and treatment of sleep and circadian disruption should be the first steps in PTSD management. State-of-the-art methods of circadian rhythm assessment should be applied to bridge the gap between clinical significance and limited understanding of the relationship between traumatic stress, sleep and circadian system.
Keywords:	Autonomic Nervous System, Chronodisruption, Circadian System, Cognition, Cortisol, Glucocorticoids, Hypothalamic-Pituitary-Adrenal Axis, Immune System, Melatonin, Memory, Posttraumatic Stress Disorder
Source:	Current Opinion in Psychiatry
ISSN:	0951-7367
Publisher:	Lippincott Williams & Wilkins
Volume:	27
Number:	5
Page Range:	385-392
Date:	September 2014
Official Publication:	https://doi.org/10.1097/YCO.0000000000000079
External Fulltext:	View full text on external repository or document server
PubMed:	View item in PubMed

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