{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T07:11:06Z","timestamp":1777965066881,"version":"3.51.4"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Clin Neurosci"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Despite being one of the most disabling symptoms of post\u2010traumatic stress disorder (PTSD)\u2014disrupting sleep continuity, reinforcing hyperarousal, and worsening psychiatric comorbidity\u2014the physiological signature of Trauma\u2010related nightmares (TRNs) under naturalistic sleep conditions remains poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We used home\u2010based, multi\u2010sensor devices from the SOMMEPT cohort to assess whether TRNs display distinct autonomic dynamics before and after awakening. TRN awakenings were self\u2010marked with the wristband button and validated through electroencephalography (EEG) inspection by a psychiatrist and a sleep physician. Each TRN event (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009412) was matched 1:1 to three control conditions: spontaneous awakenings in 60 healthy military participants, awakenings in 34 military PTSD patients without TRNs, and non\u2010nightmare awakenings from 74 military PTSD patients with TRNs. Pre\u2010awakening autonomic activity was analyzed over 10 min, and post\u2010awakening reactivity over a 2\u2010min window using nonparametric statistics with cluster\u2010based permutation correction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>TRNs were associated with heightened sudomotor activity and reduced vagal heart rate variability compared with spontaneous awakenings in healthy controls; differences were weaker versus PTSD patients without TRNs or non\u2010TRN awakenings. Phasic Electrodermal activity (EDA) showed earlier peaks and prolonged recovery, while movement was lower before TRN\u2010related awakenings. Post\u2010awakening, TRNs elicited an abrupt surge: heart rate accelerated within ~40\u2009s and normalized by ~2 min; tonic EDA remained elevated, phasic EDA bursts were longer, slower to recover, and motor activity rose during the first ~80\u2009s.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TRNs display a distinctive autonomic pattern with pre\u2010awakening sudomotor buildup and post\u2010awakening cardiovascular\u2013electrodermal surges, supporting biomarker\u2010based detection and targeted intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov Identifier: NCT04581850.<\/jats:p>\n                  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