Combat exposure, post-traumatic stress symptoms, and health-related behaviors: the role of sleep continuity and duration

Osgood, Jeffrey M.; Finan, Patrick H.; Hinman, Sarah; So, Christine J.; Quartana, Phillip J.

doi:10.1093/sleep/zsy257

Cited by 17 publications

(4 citation statements)

References 67 publications

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“…On the other hand, pre-existing insomnia puts individuals at elevated risk of developing posttraumatic stress disorder when exposed to a traumatic event (140,420). Likewise, post-deployment sleep continuity disturbance co-determines whether combat exposure results in post-traumatic stress symptoms (294).…”

Section: Insomnia By Insufficient Overnight Adaptation To Emotionamentioning

confidence: 99%

Brain mechanisms of insomnia: new perspectives on causes and consequences

Someren

2021

Physiological Reviews

289

179

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While insomnia is the second most common mental disorder, progress in our understanding of underlying neurobiological mechanisms has been limited. The present review addresses the definition and prevalence of insomnia and explores its subjective and objective characteristics across the 24-hour day. Subsequently, the review extensively addresses how the vulnerability to develop insomnia is affected by gene variants, early life stress and major life events and brain structure and function. Further supported by the clear mental health risks conveyed by insomnia, the integrated findings suggest that the vulnerability to develop insomnia could rather be found in brain circuits regulating emotion and arousal than in circuits involved in circadian and homeostatic sleep regulation. Finally, a testable model is presented. The model proposes that in people with a vulnerability to develop insomnia, the locus coeruleus is more sensitive to - or receives more input from - the salience network and related circuits, even during REM sleep, when it should normally be sound asleep. This vulnerability may ignite a downwards spiral of insufficient overnight adaptation to distress, resulting in accumulating hyperarousal which in turn impedes restful sleep and moreover increases the risk of other mental health adversity. Sensitized brain circuits are likely to be subjectively experienced as "sleeping with one eye open". The proposed model opens up the possibility for novel intervention studies and animal studies, thus accelerating the ignition of a neuroscience of insomnia, which is direly needed for better treatment.

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Section: Insomnia By Insufficient Overnight Adaptation To Emotionamentioning

confidence: 99%

Brain mechanisms of insomnia: new perspectives on causes and consequences

Someren

2021

Physiological Reviews

289

179

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“…Research shows that compared to service members who endorsed none to minimal sleep problems, those who endorsed moderate to severe problems with sleep onset and sleep maintenance had higher odds of being a smoker, having hypertension, and having a diagnosis of depression (Ulmer et al, 2015). Service members who had combat exposure and slept less than six hours a night during postdeployment endorsed aggression, alcohol use, and opioid use (Osgood, Finan, Hinman, So, & Quartana, 2019). The role of SD and other PTSD symptoms in mediating between deployment exposure and physiological health outcomes is well-known in the literature (Armenta et al, 2018).…”

Section: Significance To Science/discipline Of Nursingmentioning

confidence: 99%

Acupuncture for Sleep Disturbances in Post-Deployment Military Service Members

Abanes¹

2019

CMR

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who have given me scholarly advice and timely feedback from across oceans as I completed this dissertation in Okinawa, Japan. Without their extensive mentorship, this project would not have been possible. I would like to thank all of my professors at Vanderbilt University School of Nursing's PhD program. With their passion in research, they have taught me how to be a diligent scientist and take this profession with great responsibility and accountability. I am especially thankful to Dr. Susie Adams for being my cheerleader throughout my graduate career. She is a true mentor, leader, and friend. I express my sincerest gratitude to Hospital Corpsman Third Class Jeric Leones, Commander Lucas Johnson, Lieutenant Kobie Smith, Ms. Silvia Olvera, L.Ac, and RN George Harris with whom I had the pleasure of working with during this dissertation. Their genuine kindness has helped me sustain my enthusiasm in launching this dissertation. My appreciation also extends to Captain David Burke who provided me gracious support in integrating my research in the outpatient mental health clinic. I am fully indebted to our U.S. military service members who supported and participated in this study. Their unwavering dedication and service to our country is the reason why this research is a worthwhile undertaking. Special thanks to my friend, Sheena, for checking on my well-being despite being 6, 263 miles away. Most of all, I owe the success of this dissertation to my loving husband, Richard, and my two wonderful children, Charity and Sebastian, who provide unrelenting encouragement, inspiration, and love. v

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“…Although the exact relationship between sleep and aggression is not clear, several studies have indicated an association between them (11). In a study of combat veterans, those who reported sleep duration of less than 6 h had the strongest association between combat exposure and posttraumatic stress, aggression, and risky behavior (14). An inverse association between hours of sleep and aggression has been found in youths (15).…”

Section: Introductionmentioning

confidence: 99%

The Predictive Properties of Violence Risk Instruments May Increase by Adding Items Assessing Sleep

et al. 2019

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Background: The psychometric instruments developed for short-term prediction of violence in psychiatric inpatients do not include variables assessing sleep. Disturbances in sleep may precede aggression in this setting. We investigated whether adding information on sleep improved the predictive properties of the Brøset Violence Checklist (BVC). Methods: The study population consists of all patients admitted to a psychiatric intensive care unit (PICU) over a 6-month period who were hospitalized for at least one night ( n = 50). Sleep observed by staff (521 nights), behavior assessed with the BVC (433 days), and aggressive incidents recorded by the Staff Observation Scale-Revised ( n = 14) were included in the analysis. Results: The ability of the BVC to predict aggressive incidents improved from AUC ROC 0.757 to AUC ROC 0.873 when a combined sleep variable including both sleep duration and night-to-night variations of sleep duration was added to the BVC recordings. The combined sleep variable did not significantly predict aggressive incidents (AUC ROC 0.653, p = 0.051). Conclusions: A sleep disturbance variable improves the predictive properties of the BVC in PICUs. Further studies of sleep duration, night-to-night variations in duration of sleep, and aggression are needed.

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Combat exposure, post-traumatic stress symptoms, and health-related behaviors: the role of sleep continuity and duration

Cited by 17 publications

References 67 publications

Brain mechanisms of insomnia: new perspectives on causes and consequences

Brain mechanisms of insomnia: new perspectives on causes and consequences

Acupuncture for Sleep Disturbances in Post-Deployment Military Service Members

The Predictive Properties of Violence Risk Instruments May Increase by Adding Items Assessing Sleep

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