The role of sleep disturbances in the maintenance of PTSD symptoms: a literature review

Post-traumatic stress disorder (PTSD) represents one of the most debilitating psychiatric conditions. Posttraumatic stress disorder is frequently accompanied by sleep disturbances, including insomnia and trauma-related nightmares, affecting up to 90% of individuals with this condition. This literature review examines the bidirectional relationship between sleep disturbances and PTSD symptoms, focusing on the role of sleep as both a symptom and a maintaining factor of the disorder. A review of empirical studies, meta-analyses, and clinical trials published between 2010 and 2025 indicates that disrupted sleep architecture contributes to impaired emotional regulation, deficits in memory consolidation, and heightened threat sensitivity, thereby exacerbating daytime PTSD symptoms. Evidence demonstrates that sleep-focused interventions, such as cognitive-behavioral therapy for insomnia (CBT-I), imagery rehearsal therapy (IRT), and pharmacological treatments, effectively reduce sleep problems and lead to improvements in core PTSD symptoms. The findings suggest that early and integrated treatment of sleep disturbances may enhance overall PTSD recovery and improve the outcomes of trauma-focused therapies.

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