When time stands still: an integrative review on the role of chronodisruption in posttraumatic stress disorder
Open accessAbstract
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.
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Chronodisruption may be the common underlying neurobiologic link.
“Such findings suggest that sleep disruption occurring after trauma exposure may represent a core, rather than a secondary pathway that mediates the enduring neurobiological correlates of ELS/CT (364, 368–370, 374, 375) and that chronodisruption may be the common underlying neurobiologic link (370, 374, 376).”
From Developmental Trajectories of Early Life Stress and Trauma: A Narrative Review on Neurobiological Aspects Beyond Stress System Dysregulation (2019) · cites this paper as [376]
The Discussion (page not available) says chronodisruption may play a central pathogenetic role in stress-related disorders and that post-trauma sleep disruption may mediate neurobiological correlates of PTSD. This supports the proposed link, but the paper frames it around PTSD rather than establishing a common underlying link for the enduring correlates of early-life stress or childhood trauma. (LLM, conf=0.82)
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Cited by
Sorted by citations
Post-traumatic stress disorder.
Yehuda, R., Hoge, C. W., McFarlane, A. C., Vermetten, E., Lanius, R. A., Nievergelt, C. M., Hobfoll, S. E., Koenen, K. C., Neylan, T. C., & Hyman, S. E. (2015) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2015.57 · Cited by 870 · see citing works
Agorastos, A., Pervanidou, P., Chrousos, G. P., & Baker, D. G. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00118 · Cited by 385 · see citing works
Self-citation
- Authors
- Agorastos, A., Kellner, M., Baker, D. G., & Otte, C.
- Affiliations
- VA San Diego Healthcare System (US)
- University Medical Center Hamburg-Eppendorf (DE)
- United States Department of Veterans Affairs (US)
- Charité – Universitätsmedizin Berlin (DE)
- Corresponding author
- Agorastos, Agorastos
- Venue
- Current Opinion in Psychiatry
- Published
- 2014-09
- Volume
- 27
- Issue
- 5
- Pages
- 385-392
- ISSN
- 0951-7367 (ISSN-L)
- OpenAlex
- W2315999906
- Cited by
- 33
- References
- 155
- Citations by year
- 2026: 2 · 2024: 1 · 2023: 2 · 2022: 5 · 2021: 4 · 2020: 2 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 3
- FWCI
- 0.34
- Type
- journal article
- Language
- en
- Open access
- green
- escholarship.org
- Locations
- Current Opinion in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- MDC Repository (Max-Delbrueck-Center for Molecular Medicine) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- post-traumatic stress disorder, circadian misalignment, circadian rhythm disruption, sleep disruption, neuroendocrine dysfunction, immune dysregulation, autonomic dysfunction, endocannabinoid system, neuropeptide Y, circadian gene expression, cognitive impairment, traumatic stress
- MeSH terms
- Circadian Rhythm, Humans, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Stress Disorders, Post-Traumatic, Stress, Psychological, Sleep Disorders, Circadian Rhythm
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