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

D. M. Wallace, S. Shafazand, A. R. Ramos, D. Z. Carvalho, H. Gardener, D. Lorenzo, W. K. Wohlgemuth

Research output: Contribution to journalArticle

43 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)850-859
Number of pages10
JournalSleep Medicine
Volume12
Issue number9
DOIs
StatePublished - Oct 2011

Keywords

  • Actigraphy
  • Insomnia
  • Post-traumatic stress disorder
  • Sleep disturbances
  • Traumatic brain injury
  • Veterans

ASJC Scopus subject areas

  • Medicine(all)

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