Associate Professor of Psychiatry & Psychology
Director, Sleep and Chronobiology Laboratories
University of Pittsburgh School of Medicine
Military Sleep Tactics and Resilience Research Program
3811 O'Hara Street
Sterling Plaza 240
Pittsburgh, PA 15213
Current Research Funding:
• W81XWH-12-2-0024 1129300 (Role: PI). US Department of Defense– USAMRAA. Dose-dependent effects of sleep
disruption on fear responses and reward processing. 2012-2017.
• W81XWH-13-PHTBI- PT130572 (Roe: Co-PI). US Department of Defense– USAMRAA. Uncovering Physiological Markers
Linking Sleep and PTSD. 2015-2018.
• W81XMH-10-2-0178 (Role: Co-I). Military Suicide Research Consortium, Defense Health Program. A Behavioral Sleep
Intervention for Suicidal Behaviors in Military Veterans: A Randomized Controlled Pilot. MSRC.
• HD069375 (Role Co-I; site PI). Security and Vigilance in Military Couples: A Dynamic Model of Sleep, Interpersonal
Relationships, and Health. 2011-2015.
• BAA 13-1 13154004. US Department of Defense– USAMRAA. (Role: Co-I) Targeted Evaluation, Action & Monitoring of
Traumatic Brain Injury (TEAM-TBI). 2013-2015.
Selected Publications (Selected from 96 publications; * denotes work conducted by trainee):
1. Germain A, Nielsen TA. Impact of imagery rehearsal treatment on distressing dreams, psychological distress, and sleep
parameters in nightmare patients. Behavioral Sleep Medicine, 1:140-154, 2003.
2. Germain A, Nielsen TA. Sleep pathophysiology in PTSD and idiopathic nightmare sufferers. Biological Psychiatry,
3. Germain A, Hall M, Krakow B, Shear MK, Buysse DJ. A brief sleep scale for posttraumatic stress disorder: Pittsburgh Sleep
Quality Index Addendum for PTSD. Journal of Anxiety Disorders, 19:233-244, 2004.
4. Germain A, Buysse DJ, Shear MK, Fayyad R, Austin C. Clinical correlates of sleep disturbance severity in posttraumatic
stress disorder. Journal of Traumatic Stress, 17:477-484, 2004.
5. Germain A, Buysse DJ, Wood AM, Nofzinger EA. Functional neuroanatomical correlates of eye movements during rapid
eye movement (REM) sleep in depressed patients. Psychiatry Research: Neuroimaging, 130(3):259-68, 2004.
6. Germain A, Nofzinger EA, Kupfer DJ, Buysse DJ. Neurobiology of NREM sleep in depression: Further evidence for
hypofrontality and thalamic dysregulation. American Journal of Psychiatry, 161:1856-1863, 2004.
7. Germain A, Caroff K, Buysse DJ, Shear MK. Sleep quality in complicated grief. Journal of Traumatic Stress, 18(4):343-346,
8. Germain A, Shear MK, Monk TH, Houck PR, Reynolds CF III, Frank E, Buysse DJ. Treating complicated grief: Effects on
sleep quality. Behavioral Sleep Medicine, 4(3):152-163, 2006.
9. Nofzinger EA, Nissen C, Germain A, Moul DE, Hall M, Price JC, Miewald JM, Buysse DJ. Regional cerebral metabolic
correlates of WASO during NREM sleep in insomnia. Journal of Clinical Sleep Medicine, 2(3):316-322, 2006.
10. Germain A, Moul DE, Franzen PL, Miewald JM, Reynolds CF III, Monk TH, Buysse DJ. Effects of a brief behavioral
treatment for late-life insomnia: Preliminary findings. Journal of Clinical Sleep Medicine, 2(4): 403-406, 2006.
11. Germain A, Nofzinger EA, Meltzer CC, Wood AM, Kupfer DJ, Moore RY, Buysse DJ. Diurnal variation in regional brain
glucose metabolism in depression. Biological Psychiatry, 62:438-445, 2007. PMCID: PMC3195370
12. Germain A, Shear MK, Hall M, Buysse DJ. Effects of a brief behavioral treatment for PTSD-related sleep disturbances: A
pilot study. Behaviour and Research Therapy, 45(3): 627-632, 2007.
13. Germain A, Buysse DJ, Nofzinger EA. Sleep-specific mechanisms underlying posttraumatic stress disorder: Integrative
review and neurobiological hypotheses. Sleep Medicine Reviews, 12(3):185-195, 2008. PMCID: PMC2490669
14. Germain A, Kupfer DJ. Circadian Rhythm Disturbances in Depression. Human Psychopharmacology: Clinical and
Experimental, 23:571-585, 2008. PMCID: PMC2612129
15. Troxel W, Germain A. Insecure attachment is an independent correlate of objective sleep disturbances in military veterans.
Sleep Medicine, 12:860-865, 2011. PMCID: PMC21925945
16. Alarcon LH, Germain A, Clontz AS, Roach E, Nicholas DH, Zenati M, Peitzman AB, Sperry JL. Predictors of post-traumatic
stress disorder following civilian trauma: highest incidence and severity of symptoms after assault. Journal of Trauma and
Acute Care Surgery, 72(3):629-637, 2012.
17. Germain A, Richardson R, Moul DE, Mammen O, Haas G, Forman SD, Rode N, Begley A., Nofzinger EA.
Placebo-controlled comparison of prazosin and cognitive-behavioral treatments for sleep disturbances in US Military
Veterans. Journal of Psychosomatic Research, 72(2):89-96, 2012. PMCID: PMC3267960
18. *Insana S, Kolko DJ, Germain A. Early-life trauma is associated with rapid eye movement sleep fragmentation among
military veterans. Biological Psychology, 89(3):570-579, 2012. PMCID: PMC3299844
19. *Hasler BP, Germain A, Nofzinger E, Kupfer DJ, Krafty RT, Rothernberger SD, James JA, Bi W, Buysse DJ. Chronotype and
diurnal patterns of positive affect and affective neural circuitry in primary insomnia. Journal of Sleep Research, 21(5):
515-526, 2012. PMCID: PMC3371278
20. *Cohen DJ, Begley A, Alman JJ, Cashmere DJ, Pietrone RN, Seres RJ, Germain A. Quantitative EEG during REM and
NREM sleep in combat-exposed veterans with and without Posttraumatic Stress Disorder. Journal of Sleep Research,
22(1):76-82, 2013. PMCID: PMC3488164
21. Troxel WM, Germain A, Buysse DJ. Clinical management of insomnia with Brief Behavioral Treatment (BBTI). Behavioral
Sleep Medicine, 10(4):266-279, 2012. PMCID: PMC3622949
22. Germain A, James J, Insana S, Herringa RJ, Mammen O, Price J, Nofzinger EA. A window into the invisible wound of war:
Functional neuroimaging of REM sleep in returning combat veterans with PTSD. Psychiatry Research, 211(2):176-9, 2013.
23. *Insana SP, Hall M, Buysse DJ, Germain A. Validation of the pittsburgh sleep quality index addendum for posttraumatic
stress disorder (PSQI-A) in U.S. male military veterans. Journal of Traumatic Stress, 26(2):192-200, 2013. PMCID:
24. Germain A. Sleep disturbances as the hallmark of PTSD: Where are we now? American Journal of Psychiatry,
170(4):372-382, 2013. PMCID: PMC4197954
25. *Herringa RJ, Phillips M, Almeida J, Insana S, Germain A. Post-traumatic stress symptoms correlate with smaller subgenual
cingulate, caudate, and insula volumes in non-medicated combat veterans. Psychiatry Research, 203(2-3):139-45, 2012.
26. *Herringa RJ, Phillips ML, Fournier JC, Kronhaus DM, Germain A. Childhood and adult trauma both correlate with dorsal
anterior cingulate activation to threat in combat veterans. Psychological Medicine, 43(7):1533-42, 2013. PMCID:
27. *McDowell AL, Filippone AB, Balbir A, Germain A, O’Donnell CP. Mild transient hypercapnia as a novel fear conditioning
stimulus allowing re-exposure during Sleep. PLoS One, 8(6):e67435, 2013. PMCID: PMC3693948
28. Troxel M, Conrad T, Germain A, Buysse J. Predictors of treatment response to brief behavioral treatment of insomnia
(BBTI) in older adults. Journal of Clinical Sleep Medicine, 15; 9(12):1281-9, 2013. PMCID: PMC3836339
29. *Bramoweth A, Germain A. Deployment-related insomnia in military personnel and veterans. Current Psychiatry Reports,
15(10):401, 2013. PMCID: PMC3832138
30. *Ebdlahad S, Nofzinger EA, James JA, Buysse DJ, Price JC, Germain A. Comparing neural correlates of REM sleep in
posttraumatic stress disorder and depression: A neuroimaging study. Psychiatry Research Neuroimaging, 30; 214(3):422-8,
2013. PMCID: PMC3869237
31. *Casement MD, Germain A. Is group imagery rehearsal for posttrauma nightmares as good at reducing PTSD symptoms as
group treatment for PTSD? Psychological Trauma: Theory, Research, Practice, and Policy, 6(3), 259-260, 2014.
32. *Stocker R, Cieply M, Paul B, Henry L, Kontos A, Germain A. Combat-related blast exposure and traumatic brain injury
influence brain glucose metabolism during REM sleep in military veterans. Neuroimage, 2;99C:207-214, 2014. PMCID:
33. Mysliwiec V, O’Reilly B, Polchinski J, Kwon HP, Germain A, Roth BJ. Trauma associated sleep disorder: A proposed
parasomnia encompassing disruptive nocturnal behaviors, nightmares and REM sleep without atonia in trauma survivors.
Journal of Clinical Sleep Medicine, 10(10), 1143-1148, 2014. PMCID: PMC4173093
34. Germain A, Richardson R, Stocker R, Mammen O, Hall M, Bramoweth A, Begley A, Rode N, Frank E, Hass G, Buysse DJ.
Treatment for insomnia in combat-exposed OEF/OIF military veterans: preliminary randomized controlled trial. Behaviour
Research and Therapy, 61:78-88, 2014. PMCID: PMC4180045
35. Lotrich F, Germain A. Decreased delta sleep ratio and elevated alpha power predict vulnerability to depression during
interferon-alpha treatment. Acta Neuropsychiatrica, in press. PMCID: In process
36. Ellis JG, Cushing T, Germain A. Treating acute insomnia: A randomized control trial of a ‘single-shot’ of cognitive behavior
therapy for insomnia. Sleep, in press. PMCID: In process
37. Edinger JD, Buysse DJ, Deriy L, Germain A, Lewin DS, Ong JC, Morgenthaler TI. Quality measures for the care of patients
with insomnia. Journal of Clinical Sleep Medicine (in press). PMCID: In process
38. Mysliwiec V, Williams S, Baxter T, Germain A, O’Reilly B, Luxton DD. Preventing sleep casualties: Understanding the
unique aspects of sleep and sleep disorders in active duty service members. Combat Stress, 3(4):8-25, 2014.
39. Germain A. Resilience and readiness through restorative sleep. Sleep, 38(2): 171-173, 2015.
• B. Sc., McGill University (Montréal, Québec, Canada), 1996
• M. Ps., Université de Montréal, (Montréal, Québec, Canada), 2000
• Ph.D., Université de Montréal, (Montréal, Québec, Canada), 2001
• Postdoctoral Fellowship, University of Pittsburgh (Pittsburgh, PA), 2001-2005
Dr. Germain’s research program focuses on the pathophysiological, neural underpinnings, and treatments of sleep disturbances comorbid with stress-related disorders, with a special emphasis on posttraumatic stress disorder (PTSD) in military populations. Her federally-funded research project focuses on the relationship between sleep and neural circuits involved in anxiety, mood, and substance use disorders. Within the context of close multidisciplinary collaborations, her research program also includes studies aimed at examining sleep in traumatic injury, including traumatic brain injury, and the moderating roles of genetic and environmental factors on neural responses to threats and rewards. Dr. Germain is a committed research mentor for medical students, undergraduate and graduate students, as well as post-doctoral fellows and residents, and junior faculty members. In addition, she is the Director of the Course in Scientific Management Leadership at the University of Pittsburgh and serves as faculty on several T32 postdoctoral training grants.