Sleep and Wellbeing Study

Relationship Between Sleep the First Night and Week After Trauma and Subsequent Intrusive Memories: a Prospective Study From the Emergency Department

Most people will experience a psychologically traumatic event, such as a life-threatening accident, at some point in their life. In the initial days after such an event, it is common to be haunted by intrusive memories: image-based memories of the event that spring to mind unbidden. Intrusive memories can be distressing in their own right, but are also a hallmark symptom of post-traumatic stress disorder (PTSD).

Sleep is important for many functions involved in how people perceive, respond to and remember events, including stressful/traumatic events. Studies with patients who have experienced traumatic events indicate that sleep disturbances in the first weeks post-trauma are associated with later PTSD symptoms. However, in a previous study with healthy volunteers exposed to experimental trauma (film footage), those who were sleep-deprived in the first night, compared to those who slept, had fewer intrusive memories in the following week. This raises the question of how sleep in the first night, but also the first week, after real-life trauma is related to subsequent intrusive memories and PTSD symptoms.

The current study is an observational study of patients recruited from a hospital emergency department after a traumatic event. After completing brief baseline questionnaires in the emergency department, participants will be asked to fill in a daily diary of their sleep and intrusive memories over the following week. Post-traumatic stress symptoms, anxiety and depression will be assessed by post/online at one week and two months. Participants will be telephoned after two months to complete an interview to assess PTSD symptoms and an optional feedback interview.

This clinical study will be the first to assess the relationship between sleep in the first night and week, and intrusive memories and mental wellbeing after real-life trauma. Findings may have implications for developing simple sleep-based preventive treatments after trauma in the future.

Study Overview

• Status: Completed
• Conditions: Sleep; Posttraumatic Stress Disorder; Intrusive Memories

• Study Type: Observational
• Enrollment (Actual): 100

Contacts and Locations

Study Locations

• United Kingdom
  • Oxfordshire
    • Oxford, Oxfordshire, United Kingdom, OX3 9DU
      • Emergency Department, John Radcliffe Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients presenting to the John Radcliffe Hospital Emergency Department after a traumatic event.

Description

Inclusion Criteria:

• Aged 18 or over
• Experienced or witnessed a traumatic event (i.e. one in which they were exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence)
• Present to the emergency department on the same day as the traumatic event
• Report memory of the event
• Fluent in written and spoken English
• Alert and orientated, Glasgow Coma Scale score (GCS) = 15
• Willing and able to give informed consent and complete study procedures

Exclusion Criteria:

• Loss of consciousness
• Current intoxication
• History of severe mental illness
• Current substance abuse or neurological condition
• Currently suicidal

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Daily diary of sleep and intrusive memories	1 week

Secondary Outcome Measures

Outcome Measure	Time Frame
Actigraphy - to assess sleep timing and duration	1 week
Impact of Event Scale-Revised (total score and subscales scores) - to assess post-trauma distress	At 1 week and 2 months
Hospital Anxiety and Depression Scale	At 1 week and 2 months
Clinician-Administered PTSD Scale	At 2 months

Other Outcome Measures

Outcome Measure	Time Frame
Feedback questionnaire	At 2 months
Optional feedback interview	After 2 months

Collaborators and Investigators

• Sponsor: University of Oxford
• Collaborators: Karolinska Institutet; Medical Research Council Cognition and Brain Sciences Unit

Publications and helpful links

General Publications

• Porcheret K, Iyadurai L, Bonsall MB, Goodwin GM, Beer SA, Darwent M, Holmes EA. Sleep and intrusive memories immediately after a traumatic event in emergency department patients. Sleep. 2020 Aug 12;43(8):zsaa033. doi: 10.1093/sleep/zsaa033.

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2016
• Primary Completion (Actual): February 1, 2018
• Study Completion (Actual): April 1, 2018

Study Registration Dates

• First Submitted: October 25, 2016
• First Submitted That Met QC Criteria: January 4, 2017
• First Posted (Estimated): January 6, 2017

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 10, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Trauma and Stressor Related Disorders; Mental Disorders; Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
• Other Study ID Numbers: 16/EM/0326; 195832 (Other Identifier: IRAS)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: It is planned to make an anonymised database available via the Open Science Framework