Night Sweats and Posttraumatic Stress Disorder (PTSD)

Studies reveal lifetime prevalence for Posttraumatic Stress Disorder (PTSD) of approximately 8% of the adult population in the United States.  An (understandably) higher statistic reveals 10-30% lifetime occurrence rate in veterans. In the past year (2013) there has been a 50% increase in diagnosed cases of PTSD in the military.

The essential feature of Posttraumatic Stress Disorder is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate.

The person’s response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior). The characteristic symptoms resulting from the exposure to the extreme trauma include: persistent re-experiencing (“flashbacks”) of the traumatic event, persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness, and persistent symptoms of increased arousal.

Traumatic events that are experienced directly, witnessed, or learned about from others include, but are not limited to, military combat, violent personal assault (sexual, physical attack, robbery, and mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a POW or in a concentration camp, natural or man-made disasters, severe automobile accidents, or being diagnosed with a life-threatening illness.

In this instance, focus is centered upon the re-experiencing of the traumatic event. Commonly the person has recurrent and intrusive recollections of the event or recurrent distressing dreams during which the event can be replayed or otherwise represented. These episodes are commonly referred to as “flashbacks” (or “night terrors” when experienced during sleeping states), are typically brief but can be associated with prolonged distress and heightened arousal. Increased arousal is measured through studies of autonomic functioning, i.e. heart rate or sweat gland activity.

The individual may also have persistent symptoms of anxiety or increased arousal that was not present before the trauma. These symptoms may include difficulty falling or staying asleep that may be due to recurrent nightmares during which the traumatic event is relived and as a result the person may experience feelings of hyper-vigilance, exaggerated startle response, and increased sweat production (night sweats).

PTSD can occur at any age, including childhood. Symptoms usually begin within the first 3 months after the trauma, although they may be delayed months, or even years. Frequently a person’s reaction to a trauma initially may be diagnosed as Acute Stress Disorder or an Anxiety Disorder. Most people experiencing a stress or anxiety disorder, such as PTSD, will be referred to a psychotherapist (commonly cognitive-behavior therapist (CBT) or to a therapy group).

Medications are nearly always used in conjunction with psychotherapy for Posttraumatic Stress Disorder. The most commonly prescribed class of medication for treatment of PTSD is selective serotonin reuptake inhibitors (SSRIs) antidepressants. These include drugs like fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). Research shows that this class of medicines tends to decrease anxiety, depression, and panic associated with PTSD, as well as reduces aggression, impulsivity, and suicidal thinking.

Other types of medications that are commonly prescribed for treatment of PTSD include antipsychotics [i.e., risperidone (Risperdal), olanzapine (Zyprexa), and quetiapine (Seroquel)], mood stabilizers [i.e., lamotigine (Lamictal), tiagbine (Gabitril), and divalproex sodium (Depakote)] and/or benzodiazapines, commonly referred to as minor tranquilizers, sleeping tablets, or anti-anxiety medications providing immediate relief of symptoms. As with any medication that interferes with hormonal production and neurotransmitters, common side effects will occur; these include, nausea, vomiting, diarrhea, increased sweat production, dizziness, drowsiness, and fatigue.

A person suffering from Posttraumatic Stress Disorder or displaying symptoms of an anxiety disorder should seek out the help of a medical professional first before trying to treat the symptoms of the disorder. Help is readily available for this commonly occurring disorder, please do not ignore the symptoms or try to self-medicate, especially because substance abuse disorder and suicide are the two most commonly co-occurring conditions with PTSD.