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Exploring the role of insomnia in the relation between PTSD and pain in veterans with polytrauma injuries.
J Head Trauma Rehabil. 2014 Jan-Feb; 29(1):44-53.JH

Abstract

BACKGROUND

Soldiers returning from Operation Enduring Freedom/Operation Iraqi Freedom experience polytrauma injuries including traumatic brain injury. Traumatic brain injury is often complicated by symptoms of insomnia, posttraumatic stress disorder (PTSD), and pain that can impact treatment and rehabilitation.

METHODS

The medical records of 137 veterans seen at a Veterans Affairs Medical Center Polytrauma clinic who sustained traumatic brain injury in combat were reviewed for this study. Demographic variables include age, sex, ethnicity, military branch, and service connection. Outcome measures include PTSD, pain, and insomnia.

RESULTS

Analyses revealed a high prevalence of PTSD, insomnia, and pain co-occurring in 51.8% of veterans. Increased PTSD symptomatology was significantly correlated with reports of more pain severity (r = 0.53), pain interference (r = 0.61), and insomnia (r = 0.67). Further analyses, controlling for service connection, indicated that insomnia partially mediated the relation between PTSD and both pain severity and interference.

CONCLUSIONS

These results highlight the overlap and complexity of presenting complaints in veterans and help identify the role of sleep disturbances in complicating diagnosis and treatment of veterans. As sleep problems reduce pain tolerance and exacerbate other symptoms, such as cognitive deficits and irritability, failure to address sleep disturbances may compromise rehabilitation efforts, suggesting the importance of a multidisciplinary team approach to assessing and treating these veterans.

Authors+Show Affiliations

Department of Psychology, The University of Memphis (Ms Lang and Drs Veazey-Morris and Andrasik), and Memphis VA Medical Center, Memphis, Tennessee (Dr Veazey-Morris).No 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

23835878

Citation

Lang, Katie P., et al. "Exploring the Role of Insomnia in the Relation Between PTSD and Pain in Veterans With Polytrauma Injuries." The Journal of Head Trauma Rehabilitation, vol. 29, no. 1, 2014, pp. 44-53.
Lang KP, Veazey-Morris K, Andrasik F. Exploring the role of insomnia in the relation between PTSD and pain in veterans with polytrauma injuries. J Head Trauma Rehabil. 2014;29(1):44-53.
Lang, K. P., Veazey-Morris, K., & Andrasik, F. (2014). Exploring the role of insomnia in the relation between PTSD and pain in veterans with polytrauma injuries. The Journal of Head Trauma Rehabilitation, 29(1), 44-53. https://doi.org/10.1097/HTR.0b013e31829c85d0
Lang KP, Veazey-Morris K, Andrasik F. Exploring the Role of Insomnia in the Relation Between PTSD and Pain in Veterans With Polytrauma Injuries. J Head Trauma Rehabil. 2014 Jan-Feb;29(1):44-53. PubMed PMID: 23835878.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exploring the role of insomnia in the relation between PTSD and pain in veterans with polytrauma injuries. AU - Lang,Katie P, AU - Veazey-Morris,Katherine, AU - Andrasik,Frank, PY - 2013/7/10/entrez PY - 2013/7/10/pubmed PY - 2014/9/18/medline SP - 44 EP - 53 JF - The Journal of head trauma rehabilitation JO - J Head Trauma Rehabil VL - 29 IS - 1 N2 - BACKGROUND: Soldiers returning from Operation Enduring Freedom/Operation Iraqi Freedom experience polytrauma injuries including traumatic brain injury. Traumatic brain injury is often complicated by symptoms of insomnia, posttraumatic stress disorder (PTSD), and pain that can impact treatment and rehabilitation. METHODS: The medical records of 137 veterans seen at a Veterans Affairs Medical Center Polytrauma clinic who sustained traumatic brain injury in combat were reviewed for this study. Demographic variables include age, sex, ethnicity, military branch, and service connection. Outcome measures include PTSD, pain, and insomnia. RESULTS: Analyses revealed a high prevalence of PTSD, insomnia, and pain co-occurring in 51.8% of veterans. Increased PTSD symptomatology was significantly correlated with reports of more pain severity (r = 0.53), pain interference (r = 0.61), and insomnia (r = 0.67). Further analyses, controlling for service connection, indicated that insomnia partially mediated the relation between PTSD and both pain severity and interference. CONCLUSIONS: These results highlight the overlap and complexity of presenting complaints in veterans and help identify the role of sleep disturbances in complicating diagnosis and treatment of veterans. As sleep problems reduce pain tolerance and exacerbate other symptoms, such as cognitive deficits and irritability, failure to address sleep disturbances may compromise rehabilitation efforts, suggesting the importance of a multidisciplinary team approach to assessing and treating these veterans. SN - 1550-509X UR - https://www.unboundmedicine.com/medline/citation/23835878/Exploring_the_role_of_insomnia_in_the_relation_between_PTSD_and_pain_in_veterans_with_polytrauma_injuries_ L2 - https://doi.org/10.1097/HTR.0b013e31829c85d0 DB - PRIME DP - Unbound Medicine ER -