To sleep or not to sleep, that is the question: a systematic review and meta-analysis on the effect of post-trauma sleep on intrusive memories of analog trauma

Abstract

Distressing intrusive memories of a traumatic event are the hallmark symptom of posttraumatic stress disorder. Thus, it is crucial to identify early interventions that prevent the occurrence of intrusive memories. Both, sleep and sleep deprivation have been discussed as interventions, yet previous studies yielded contradicting effects. Our systematic review aims at evaluating existing evidence by means of traditional and individual participant data (IPD) meta-analyses to overcome power issues of sleep research. Until May 16th 2022, six databases were searched for experimental analog studies examining the effect of post-trauma sleep versus wakefulness on intrusive memories. Nine studies were included in our traditional meta-analysis (8 in the IPD meta-analysis). Our analysis provided evidence for a small effect favoring sleep over wakefulness, M(log-ROM) = 0.25, p < .001, suggesting that sleep is associated with a lower number of intrusions but unrelated to the likelihood of the occurrence of intrusions. We found no evidence for an effect of sleep on intrusion distress. Heterogeneity was low and certainty of evidence for our primary analysis was moderate. Our findings suggest that post-trauma sleep has the potential to be protective by reducing intrusion frequency. More research is needed to determine the impact following real-world trauma and the potential clinical significance.

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ORCID for Emily A. Holmes: orcid.org/0000-0001-7319-3112

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