Sleep Disturbances in the Vietnam Generation: Findings From a Nationally Representative Sample of Male Vietnam Veterans

Neylan, Thomas C.; Marmar, Charles R.; Metzler, Thomas J.; Weiss, Daniel S.; Zatzick, Douglas; Delucchi, Kevin; Wu, Roger M.; Schoenfeld, Frank B.

doi:10.1176/ajp.155.7.929

Cited by 409 publications

(264 citation statements)

References 29 publications

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“…4 Trauma-related nightmares in PTSD are more severe than non-trauma-related nightmares in terms of increased frequency and association with more frequent awakenings and worse sleep maintenance. 5,6 In the National Comorbidity Survey Replication of American adults, the lifetime prevalence of PTSD was 6.8%. 7 With an increasing number of veterans of military deployments being reintegrated into civilian life, physicians can expect to see more patients with symptoms of PTSD, including nightmares and reduced sleep quality.…”

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confidence: 99%

Treatment of Nightmares With Prazosin: A Systematic Review

Kung

Espinel

Lapid

2012

Mayo Clinic Proceedings

258

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Nightmares, frequently associated with posttraumatic stress disorder and clinically relevant in today's world of violence, are difficult to treat, with few pharmacologic options. We performed a systematic review to evaluate the evidence for the use of prazosin in the treatment of nightmares. A comprehensive search was performed using the databases EMBASE, Ovid MEDLINE, PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews, from their inception to March 9, 2012, using keywords prazosin and nightmares/PTSD or associated terms (see text). Two authors independently reviewed titles and abstracts and selected relevant studies. Descriptive data and outcomes of interest from eligible studies were extracted by 1 author, and checked by 2 others. The risk of bias of randomized controlled trials (RCTs) was assessed independently by 2 reviewers. Articles met criteria for inclusion if prazosin was used to treat nightmares, and outcome measures included nightmares or related symptoms of sleep disorders. Our search yielded 21 studies, consisting of 4 RCTs, 4 open-label studies, 4 retrospective chart reviews, and 9 single case reports. The prazosin dose ranged from 1 to 16 mg/d. Results were mixed for the 4 RCTs: 3 reported significant improvement in the number of nightmares, and 1 found no reduction in the number of nightmares. Reduced nightmare severity with use of prazosin was consistently reported in the open-label trials, retrospective chart reviews, and single case reports.

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confidence: 99%

Treatment of Nightmares With Prazosin: A Systematic Review

Kung

Espinel

Lapid

2012

Mayo Clinic Proceedings

258

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“…Several representative studies have reported nightmare incidences of 50-70% in adults suffering from PTSD (Kilpatrick, et al, 1998;Leskin, Woodward, Young, & Sheikh, 2002;Neylan, et al, 1998) results. One large scale study including Kurdish children indicated that trauma exposure was related to more realistic dreams lacking in bizarreness and symbolism (Punamäki, Ali, Ismahil, & Nuutinen, 2005).…”

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confidence: 99%

“…Several representative studies have reported nightmare incidences of 50-70% in adults suffering from PTSD (Kilpatrick, et al, 1998;Leskin, Woodward, Young, & Sheikh, 2002;Neylan, et al, 1998). Many studies have shown an association between posttraumatic nightmares and indicators of functional impairment, such as psychiatric symptoms, time off work, psychosomatic reactivity, and sleep problems (e.g., Holen, 1990;Neylan et al, 1998).…”

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confidence: 99%

Posttraumatic nightmares and psychopathology in children after road traffic accidents

Wittmann

Zehnder

Schredl

et al. 2010

Journal of Traumatic Stress

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Tables: 504 Total: 5'799 2 Abstract Posttraumatic nightmares are considered as a re-experiencing symptom of the DSM-IV posttraumatic stress disorder (PTSD) diagnosis. Different types of posttraumatic nightmares, however, may differ in their relation to psychopathology. Thirty-two children were longitudinally assessed ten days, two, and six months after traffic accidents. Occurrence and characteristics of nightmares were examined and their relation to psychopathology assessed.Thirty-four percent of children reported posttraumatic nightmares during at least one assessment. Exact replicative nightmares at baseline assessment predicted PTSD symptoms two and six months postaccident, but not depressive symptoms. Exact replicative nightmares revealed the strongest cross-sectional association with trauma-specific psychopathology but not with depression. We conclude that posttraumatic nightmares -especially exact replicative ones -may be closely related to psychopathological mechanisms of posttraumatic stress in children. 3Survivors of potentially traumatic events such as accidents, disasters or acts of violence often suffer from psychopathological sequelae. In particular, symptoms of acute or posttraumatic stress disorder (ASD / PTSD; American Psychicatric Association (APA), 1994), such as re-experiencing the traumatic event, avoiding traumatic stimuli, and hyperarousal are frequently reported (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995).Frequent complaints of individuals suffering from posttraumatic stress are nightmares.Usually, nightmares are defined as frightening dreams from which the dreamer awakes (e.g., . Several representative studies have reported nightmare incidences of 50-70% in adults suffering from PTSD (Kilpatrick, et al., 1998;Leskin, Woodward, Young, & Sheikh, 2002;Neylan, et al., 1998) results. One large scale study including Kurdish children indicated that trauma exposure was related to more realistic dreams lacking in bizarreness and symbolism (Punamäki, Ali, Ismahil, & Nuutinen, 2005). However, a detailed examination of the worst dreams experienced by 13 teenage girls following severe sexual abuse showed a different picture (Garfield, 1987). In this sample, dreams contained no explicit replications but only symbolic references to the traumatic experiences.Several theories propose that posttraumatic nightmares are related to the central pathological mechanism of posttraumatic stress disorder (Kramer, Schoen, & Kinney, 1984;Schreuder, 1995;Stickgold, 2002). For instance, Stickgold (2002) In the first assessment (10 days after the accident) the number of nightmares (introduced as "frightening dreams") since the accident was examined. At the assessments two and six months postaccident, nightmare frequency since the accident was assessed through the nightmare frequency scale of the CAPS item B2. This scale ranges from 0 = never and 1 = 1-2 times a month to 4 = almost every day. In order to keep the nightmare interview as simple as possible, it was not asked how many of the frightening dreams we...

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“…Among those meeting diagnostic criteria for posttraumatic stress disorder (PTSD), the prevalence of insomnia and other sleep difficulties is even greater. An estimated 10-25 % of Veterans deployed to Iraq and Afghanistan have returned with PTSD (Tanielian & Jaycox, 2008), and up to 90 % of these Veterans are likely to endorse difficulty maintaining sleep (Neylan et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

Associations between sleep difficulties and risk factors for cardiovascular disease in veterans and active duty military personnel of the Iraq and Afghanistan conflicts

et al. 2015

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Recent evidence suggests that sleep disturbance may play an important role in the development of cardiovascular disease (CVD). Despite the prevalence of sleep complaints among service members of recent military conflicts, few studies have examined associations between sleep and risk factors for CVD in this population. Symptom checklist items regarding distress about "trouble falling asleep" and "restless/disturbed sleep" were used as proxies for sleep onset and maintenance difficulties to examine these associations in US military service members of recent conflicts. Veterans having both sleep onset and maintenance difficulties had greater odds of being a current smoker and having psychiatric symptoms and diagnoses. Increased odds of a self-reported hypertension diagnosis and elevated systolic blood pressure were also found in certain subsets of this sample. Findings highlight the need for greater recognition of sleep difficulties as a CVD risk factor in a population known to be at increased risk for this condition.

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Sleep Disturbances in the Vietnam Generation: Findings From a Nationally Representative Sample of Male Vietnam Veterans

Abstract: Frequent nightmares appear to be virtually specific for PTSD. The nightmare is the domain of sleep disturbance most related to exposure to war zone traumatic stress.

Cited by 409 publications

References 29 publications

Treatment of Nightmares With Prazosin: A Systematic Review

Treatment of Nightmares With Prazosin: A Systematic Review

Posttraumatic nightmares and psychopathology in children after road traffic accidents

Associations between sleep difficulties and risk factors for cardiovascular disease in veterans and active duty military personnel of the Iraq and Afghanistan conflicts

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