The Neuroscience of Sleep and Consciousness in PTSD: The Role of REM Sleep Neural Circuits in Emotional Regulation - A Systematic Review

PTSD is associated with significant disruptions in REM sleep, which play a central role in emotional regulation and memory consolidation. This systematic review examines human neuroimaging studies published between 2014 and 2024 that investigate the relationship between REM sleep, neural circuits, and PTSD, with a focus on emotional processing. The findings reveal consistent alterations in key brain regions—including the amygdala, hippocampus, and prefrontal cortex—during REM sleep in individuals with PTSD, suggesting that dysfunctional neural activity in these areas may contribute to symptoms such as hyperarousal, intrusive memories, and emotional dysregulation. These results support the growing view that REM sleep disturbances are not merely a consequence but may be a core feature of PTSD pathology. Clinical interventions aimed at modulating REM sleep, such as cognitive behavioral therapy for insomnia and lucid dreaming techniques, may offer promising avenues for symptom reduction. Future research should prioritize longitudinal designs and consider individual differences in REM sleep neurophysiology to better understand the causal mechanisms underlying these associations.