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Insomnia characteristics and clinical correlates in Operation Enduring Freedom/Operation Iraqi Freedom veterans with post-traumatic stress disorder and mild traumatic brain injury: an exploratory study.
Sleep Med. 2011 Oct; 12(9):850-9.SM

Abstract

BACKGROUND

There is limited data on chronic insomnia in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, in whom post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) often co-exist. Our aim was to compare sleep characteristics of three groups of OEF/OIF veterans: (1) healthy sleepers (HS), (2) those with insomnia associated with PTSD and mTBI (PTSD-mTBI), and (3) those with insomnia associated with PTSD alone.

METHODS

Consecutive veterans with insomnia complaints (> 6 months) were recruited over 6 months from the Miami VA Post Deployment clinic. Participants completed a sleep disorders clinical interview, medical history, and questionnaires about insomnia, sleepiness, pain, fatigue, depression, PTSD, and health-related quality of life. They underwent polysomnography (PSG) with 2 weeks of actigraphy (ACT) and sleep diaries.

RESULTS

There were no differences in demographics or most questionnaire responses between PTSD and PTSD-mTBI groups. Subjective daytime sleepiness was significantly greater in PTSD-mTBI subjects compared with HS and PTSD participants. Significant co-morbid sleep disorders were noted in insomnia patients. PSG and ACT wake after sleep onset was significantly shorter in PTSD-mTBI subjects as compared with PTSD participants.

CONCLUSION

Insomnia patients with PTSD-mTBI were subjectively sleepier despite spending less time awake during the night than PTSD subjects, possibly as a consequence of head trauma.

Authors+Show Affiliations

Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA. dwallace@med.miami.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

21925943

Citation

Wallace, D M., et al. "Insomnia Characteristics and Clinical Correlates in Operation Enduring Freedom/Operation Iraqi Freedom Veterans With Post-traumatic Stress Disorder and Mild Traumatic Brain Injury: an Exploratory Study." Sleep Medicine, vol. 12, no. 9, 2011, pp. 850-9.
Wallace DM, Shafazand S, Ramos AR, et al. Insomnia characteristics and clinical correlates in Operation Enduring Freedom/Operation Iraqi Freedom veterans with post-traumatic stress disorder and mild traumatic brain injury: an exploratory study. Sleep Med. 2011;12(9):850-9.
Wallace, D. M., Shafazand, S., Ramos, A. R., Carvalho, D. Z., Gardener, H., Lorenzo, D., & Wohlgemuth, W. K. (2011). Insomnia characteristics and clinical correlates in Operation Enduring Freedom/Operation Iraqi Freedom veterans with post-traumatic stress disorder and mild traumatic brain injury: an exploratory study. Sleep Medicine, 12(9), 850-9. https://doi.org/10.1016/j.sleep.2011.06.004
Wallace DM, et al. Insomnia Characteristics and Clinical Correlates in Operation Enduring Freedom/Operation Iraqi Freedom Veterans With Post-traumatic Stress Disorder and Mild Traumatic Brain Injury: an Exploratory Study. Sleep Med. 2011;12(9):850-9. PubMed PMID: 21925943.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insomnia characteristics and clinical correlates in Operation Enduring Freedom/Operation Iraqi Freedom veterans with post-traumatic stress disorder and mild traumatic brain injury: an exploratory study. AU - Wallace,D M, AU - Shafazand,S, AU - Ramos,A R, AU - Carvalho,D Z, AU - Gardener,H, AU - Lorenzo,D, AU - Wohlgemuth,W K, Y1 - 2011/09/16/ PY - 2011/04/06/received PY - 2011/05/20/revised PY - 2011/06/01/accepted PY - 2011/9/20/entrez PY - 2011/9/20/pubmed PY - 2012/3/9/medline SP - 850 EP - 9 JF - Sleep medicine JO - Sleep Med VL - 12 IS - 9 N2 - BACKGROUND: There is limited data on chronic insomnia in Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans, in whom post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) often co-exist. Our aim was to compare sleep characteristics of three groups of OEF/OIF veterans: (1) healthy sleepers (HS), (2) those with insomnia associated with PTSD and mTBI (PTSD-mTBI), and (3) those with insomnia associated with PTSD alone. METHODS: Consecutive veterans with insomnia complaints (> 6 months) were recruited over 6 months from the Miami VA Post Deployment clinic. Participants completed a sleep disorders clinical interview, medical history, and questionnaires about insomnia, sleepiness, pain, fatigue, depression, PTSD, and health-related quality of life. They underwent polysomnography (PSG) with 2 weeks of actigraphy (ACT) and sleep diaries. RESULTS: There were no differences in demographics or most questionnaire responses between PTSD and PTSD-mTBI groups. Subjective daytime sleepiness was significantly greater in PTSD-mTBI subjects compared with HS and PTSD participants. Significant co-morbid sleep disorders were noted in insomnia patients. PSG and ACT wake after sleep onset was significantly shorter in PTSD-mTBI subjects as compared with PTSD participants. CONCLUSION: Insomnia patients with PTSD-mTBI were subjectively sleepier despite spending less time awake during the night than PTSD subjects, possibly as a consequence of head trauma. SN - 1878-5506 UR - https://www.unboundmedicine.com/medline/citation/21925943/Insomnia_characteristics_and_clinical_correlates_in_Operation_Enduring_Freedom/Operation_Iraqi_Freedom_veterans_with_post_traumatic_stress_disorder_and_mild_traumatic_brain_injury:_an_exploratory_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1389-9457(11)00219-X DB - PRIME DP - Unbound Medicine ER -