Study Title: Sleep and emotion processing in adolescent Post-traumatic stress disorder Principal Investigators: Stephanie Jones, PhD and Ryan Herringa, MD, PhD Project Summary Although nearly all affective disorders are associated with sleep pathology, PTSD is singularly conceptualized as one in which functionally impairing symptoms, including trauma re-experiencing and hyperarousal, are present across the 24- hour period—during both wake and sleep. As such, sleep pathology has been reconceptualized from a highly comorbid symptom with little mechanistic value to a function that is fundamentally involved in the development, maintenance, and severity of the disorder. Remarkably, sleep research in youth with PTSD has relied almost exclusively on subjective assessments of sleep, which afford no information about the sleeping brain. This gap is particularly relevant given the overlap between the functional impairments, both neural and behavioral, associated with PTSD and those associated with poor quality sleep. In this proposal, we will explore sleep’s relationship to emotion processing and daily affect in 165 adolescents between 15-18 years spilt into 3 groups: PTSD, TEC (trauma-exposed comparison) and TD (typically developing). We will use advanced sleep assessment methodologies including: (1) high-density EEG (256 channels) in the laboratory to explore the regional distribution of sleep before and after an emotional learning task and; (2) a sleep-wearable EEG recording headband, SmartSleep, to record sleep in the ecologically relevant home-environment, longitudinally, (14 days) and explore its relationship to daily measures of affect and symptom severity. Finally, to determine whether the deepest sleep (e.g. slow-wave activity (SWA); EEG frequency 1-4 hertz) of non-rapid eye-movement sleep (NREM)) can be reliably increased over time in youth, during one 5-day period of sleep recording, we will increase SWA using SmartSleep’s acoustic enhancement algorithms. These algorithms represent the first validated, non-pharmacological method available for enhancing slow-waves. Our long-term goal is to understand the role sleep plays in the maintenance and progression of adolescent PTSD. We expect our results will have a significant impact on our understanding of sleep pathophysiology in adolescent PTSD and to lay groundwork for larger clinical trials to test novel sleep neuromodulatory interventions.