Tags

Type your tag names separated by a space and hit enter

Longitudinal relationships of insomnia, nightmares, and PTSD severity in recent combat veterans.
J Psychosom Res. 2013 Dec; 75(6):546-50.JP

Abstract

OBJECTIVE

This observational, longitudinal study of veterans with recent combat exposure describes the prevalence, severity and associations of posttraumatic stress disorder (PTSD), insomnia, and nightmares over time.

METHODS

Eighty recent combat veterans recruited from Veterans Health Administration primary care settings met inclusion criteria including hazardous alcohol use and at least subthreshold PTSD. Insomnia status and nightmare status were assigned based on the Insomnia Severity Index total score and the PTSD Checklist nightmare item, respectively. Participants were re-assessed six months following their baseline assessment. Analyses of variance compared insomnia and nightmare groups on PTSD, depression, and alcohol use severity. Analyses of covariance (controlling for baseline differences) examined whether insomnia and/or nightmares were associated with the clinical course of PTSD. Persistence of conditions was also examined.

RESULTS

At baseline, 74% presented with insomnia and 61% endorsed distressing nightmares. Insomnia was associated with significantly higher PTSD and depression severity at both baseline and six months. The presence of nightmares was associated with significantly higher PTSD severity at both time points and with depression severity at baseline only. Despite decreases in PTSD and depression severity, insomnia severity was relatively unchanged after six months. The prevalence and severity of nightmare complaints diminished modestly over time.

CONCLUSION

Among this sample of recent combat veterans, insomnia and nightmares were each strongly associated with the severity of both PTSD and depressive symptoms. Over time, insomnia in particular did not appear to resolve spontaneously and was associated with ongoing PTSD. Addressing insomnia early, therefore, may be a strategy to alter the course of PTSD.

Authors+Show Affiliations

Center of Excellence for Suicide Prevention, Canandaigua VA Medical Center, Canandaigua, NY, United States; Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, United States; Psychiatry Department, University of Rochester Medical Center, Rochester, NY, United States. Electronic address: Wilfred_Pigeon@urmc.rochester.edu.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24290044

Citation

Pigeon, Wilfred R., et al. "Longitudinal Relationships of Insomnia, Nightmares, and PTSD Severity in Recent Combat Veterans." Journal of Psychosomatic Research, vol. 75, no. 6, 2013, pp. 546-50.
Pigeon WR, Campbell CE, Possemato K, et al. Longitudinal relationships of insomnia, nightmares, and PTSD severity in recent combat veterans. J Psychosom Res. 2013;75(6):546-50.
Pigeon, W. R., Campbell, C. E., Possemato, K., & Ouimette, P. (2013). Longitudinal relationships of insomnia, nightmares, and PTSD severity in recent combat veterans. Journal of Psychosomatic Research, 75(6), 546-50. https://doi.org/10.1016/j.jpsychores.2013.09.004
Pigeon WR, et al. Longitudinal Relationships of Insomnia, Nightmares, and PTSD Severity in Recent Combat Veterans. J Psychosom Res. 2013;75(6):546-50. PubMed PMID: 24290044.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Longitudinal relationships of insomnia, nightmares, and PTSD severity in recent combat veterans. AU - Pigeon,Wilfred R, AU - Campbell,Clare E, AU - Possemato,Kyle, AU - Ouimette,Paige, Y1 - 2013/10/02/ PY - 2013/04/10/received PY - 2013/08/30/revised PY - 2013/09/25/accepted PY - 2013/12/3/entrez PY - 2013/12/3/pubmed PY - 2014/10/8/medline KW - Insomnia KW - Military KW - Nightmares KW - Posttraumatic stress disorder KW - Veterans SP - 546 EP - 50 JF - Journal of psychosomatic research JO - J Psychosom Res VL - 75 IS - 6 N2 - OBJECTIVE: This observational, longitudinal study of veterans with recent combat exposure describes the prevalence, severity and associations of posttraumatic stress disorder (PTSD), insomnia, and nightmares over time. METHODS: Eighty recent combat veterans recruited from Veterans Health Administration primary care settings met inclusion criteria including hazardous alcohol use and at least subthreshold PTSD. Insomnia status and nightmare status were assigned based on the Insomnia Severity Index total score and the PTSD Checklist nightmare item, respectively. Participants were re-assessed six months following their baseline assessment. Analyses of variance compared insomnia and nightmare groups on PTSD, depression, and alcohol use severity. Analyses of covariance (controlling for baseline differences) examined whether insomnia and/or nightmares were associated with the clinical course of PTSD. Persistence of conditions was also examined. RESULTS: At baseline, 74% presented with insomnia and 61% endorsed distressing nightmares. Insomnia was associated with significantly higher PTSD and depression severity at both baseline and six months. The presence of nightmares was associated with significantly higher PTSD severity at both time points and with depression severity at baseline only. Despite decreases in PTSD and depression severity, insomnia severity was relatively unchanged after six months. The prevalence and severity of nightmare complaints diminished modestly over time. CONCLUSION: Among this sample of recent combat veterans, insomnia and nightmares were each strongly associated with the severity of both PTSD and depressive symptoms. Over time, insomnia in particular did not appear to resolve spontaneously and was associated with ongoing PTSD. Addressing insomnia early, therefore, may be a strategy to alter the course of PTSD. SN - 1879-1360 UR - https://www.unboundmedicine.com/medline/citation/24290044/Longitudinal_relationships_of_insomnia_nightmares_and_PTSD_severity_in_recent_combat_veterans_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3999(13)00344-9 DB - PRIME DP - Unbound Medicine ER -