Dr. Matt Walker

In fact, repetitive nightmares form part of the diagnostic criteria for you to receive a diagnosis of PTSD.

That's how reliable they are.

And as I thought more about this model of overnight therapy, this notion that sleep, and particularly REM sleep, provides a form of emotional first aid, PTSD stood out to me as something that I had to return to to explain.

Why?

if you think about ptsd and a veteran it is the perfect example of the process that i described of emotional deep potentiation failing because what i started to realize is that in ptsd there is this trauma experience and then perhaps what's happening is that sleep

the brain goes back to sleep that night and says, okay, please do your elegant trick of stripping away the emotion from the memory, and it fails.

So then what happens the next night?

The brain comes back and says, I'm sorry, but I still got this very emotionally charged memory.

Please do your elegant dissipation, depotentiation of the emotion from memory, and it fails again, almost like this broken record that was so indicative of these repetitive nightmares.

And then when you looked at PTSD, I told you that REM sleep is a time of this remarkable decrease in noradrenaline.

But if you look at PTSD patients, they actually have heightened levels of noradrenaline and also in the body adrenaline as well.

In sleep?

In sleep and also when you look just as a basal state as well.

So there's something not quite right with the noradrenaline story in REM sleep in PTSD patients.

So I had just published this paper and I was up at a conference in, I think it was Portland,

And I presented the theory that, or the data that we had on healthy people, and I put forward this theory of PTSD.

And then later that afternoon, a psychiatrist came on the stage called Murray Raskin, and he was working a lot with PTSD vets.

And he described data, which I couldn't believe.

It's one of those moments, Andrew, where you're at a scientific conference.

And I think it happens maybe once in a career, if you're lucky.