Sleep quality in treatment-seeking veterans of Operations Enduring Freedom and Iraqi Freedom: The role of cognitive coping strategies and unit cohesion

Pietrzak, Robert H.; Morgan, Charles A.; Southwick, Steven M.

doi:10.1016/j.jpsychores.2010.07.002

Cited by 36 publications

(28 citation statements)

References 56 publications

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“…4 PTSD is a costly disorder to the individual and society, as it affects overall quality of life, interpersonal relationships, job performance, and mental and emotional well-being. 1,3,5 Another debilitating condition that has been associated with both PTSD and trauma exposure itself is difficulty sleeping. Sleep disturbances are reported following a wide variety of traumatic events and are also commonly endorsed by those individuals in whom PTSD develops.…”

Section: Introductionmentioning

confidence: 99%

“…Sleep disturbances are reported following a wide variety of traumatic events and are also commonly endorsed by those individuals in whom PTSD develops. [5][6][7][8] Moreover, such disturbance is a key component of PTSD diagnostic criteria. 9 It is well documented that sleep complaints are common among OEF/OIF veterans, 5,10,11 particularly those returning from combat zones.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8] Moreover, such disturbance is a key component of PTSD diagnostic criteria. 9 It is well documented that sleep complaints are common among OEF/OIF veterans, 5,10,11 particularly those returning from combat zones. 8 However, most studies of sleep in veteran populations have focused on comparisons across individuals with and without PTSD, 5,8,11 neglecting examination of the specific effects that trauma exposure itself may have on sleep in this BRIEF SUMMARY Current Knowledge/Study Rationale: Although it is well established that veterans (particularly those with PTSD) have poor sleep and many studies have examined this, few studies have investigated how sleep may differ in a three-group model (controls without trauma exposure, trauma-exposed individuals, and individuals with PTSD).…”

Section: Introductionmentioning

confidence: 99%

“…14,15 Fragmentation in rapid eye movement sleep specifically is predictive of PTSD. [16][17][18] Numerous studies have been conducted to identify correlates of sleep disturbance in veteran samples, 5,7 yet few have incorporated a three-group design that separates "true" controls from trauma-exposed controls and individuals with PTSD. In one of the first studies that examined factors beyond demographics and psychopathology in OEF/OIF veterans, positive cognitive coping strategies (such as cognitive distraction) and unit support demonstrated negative associations with sleep problems in individuals with PTSD.…”

Section: Introductionmentioning

confidence: 99%

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Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping

Lind

Brown

Farrell-Carnahan

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: Sleep disturbances are well documented in relation to trauma exposure and posttraumatic stress disorder (PTSD), but correlates of such disturbances remain understudied in veteran populations. We conducted a preliminary study of sleep disturbances in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (n = 133; mean [standard deviation] age = 29.8 [4.7] y). Methods: Veterans were assigned to one of three groups based on responses to the Clinician Administered PTSD Scale: control (no trauma-exposure [TE] or PTSD), TE, and PTSD. Sleep disturbance was assessed using the Pittsburgh Sleep Quality Index (PSQI). Measures of resilience, trauma load, personality, coping, alcohol use, and mild traumatic brain injury were also assessed via self-report. Results: The PTSD group had significantly more disturbed sleep (PSQI global score mean = 8.94, standard deviation = 3.12) than control (mean = 5.27, standard deviation = 3.23) and TE (mean = 5.34, standard deviation = 3.17) groups, but there were no differences between TE and control. The same pattern emerged across most PSQI subscales. Results of linear regression analyses indicated that current smoking, Army (versus other military branches), neuroticism, and using substances to cope were all significant correlates of higher sleep disturbance, whereas post-deployment social support was associated with less sleep disturbance. However, when combined together into a model with PTSD status, only neuroticism and substance use coping remained significant as predictors of more disturbed sleep. Conclusions: These initial findings suggest that TE itself may not be an independent risk factor for disturbed sleep in veterans, and that neurotic personality and a tendency to cope by using substances may partially explain sleep disturbance, above and beyond a diagnosis of PTSD.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping

Lind

Brown

Farrell-Carnahan

et al. 2017

Journal of Clinical Sleep Medicine

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“…Impaired sleep commonly accompanies PTSD in U.S. OIF/OEF veterans [30][31]. This study employed an intervention to improve sleep by reducing the frequency and severity of nightmares that disrupt sleep [22].…”

Section: Discussionmentioning

confidence: 99%

For veterans with mild traumatic brain injury, improved posttraumatic stress disorder severity and sleep correlated with symptomatic improvement

Ruff

Riechers²,

Wang³

et al. 2012

JRRD

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Abstract-This was an observational study of a cohort of 63 Operation Iraqi Freedom/Operation Enduring Freedom veterans with mild traumatic brain injury (mTBI) associated with an explosion. They had headaches, residual neurological deficits (NDs) on neurological examination, and posttraumatic stress disorder (PTSD) and were seen on average 2.5 years after their last mTBI. We treated them with sleep hygiene counseling and oral prazosin. We monitored headache severity, daytime sleepiness using the Epworth Sleepiness Scale, cognitive performance using the Montreal Cognitive Assessment test, and the presence of NDs. We quantitatively measured olfaction and assessed PTSD severity using the PTSD Checklist-Military Version. Nine weeks after starting sleep counseling and bedtime prazosin, the veterans' headache severity decreased, cognitive function as assayed with a brief screening tool improved, and daytime sleepiness diminished. Six months after completing treatment, the veterans demonstrated additional improvement in headache severity and daytime sleepiness and their improvements in cognitive function persisted. There were no changes in the prevalence of NDs or olfaction scores. Clinical improvements correlated with reduced PTSD severity and daytime sleepiness. The data suggested that reduced clinical manifestations following mTBI correlated with PTSD severity and improvement in sleep, but not the presence of NDs or olfaction impairment.

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An integrated model of chronic trauma‐induced insomnia

Roberge

Bryan

2020

Clin Psychology and Psychoth

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Insomnia is the most commonly reported symptom of posttraumatic stress disorder (PTSD), with at least 70% of patients with PTSD reporting disturbed sleep. Although posttraumatic insomnia has traditionally been conceptualized as a consequence of PTSD, it is the most likely symptom to not remit following otherwise successful PTSD treatment. This suggests that the relationship between PTSD and insomnia is more complex, such that they likely share underlying pathological mechanisms and that factors non‐specific to PTSD maintain chronic trauma‐induced insomnia. Although several theories and hypotheses have been presented to explain the relationship between PTSD and insomnia, neurobiological and psychological models have not been integrated, thereby limiting their comprehensiveness and abilities to inform effective intervention. Further, existing models have not addressed how acute trauma‐induced insomnia becomes chronic. The present review examined models of PTSD and insomnia separately, as well as existing theorized mechanisms of their co‐morbidity. The distinct characteristics of trauma‐induced insomnia were also reviewed and presented to describe the unique clinical presentation of trauma‐induced insomnia. Review and integration of the literature were used to propose an integrated model of chronic trauma‐induced insomnia informed by a neuropsychobiological framework. Clinical implications and future research directions are presented and discussed.

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Sleep quality in treatment-seeking veterans of Operations Enduring Freedom and Iraqi Freedom: The role of cognitive coping strategies and unit cohesion

Cited by 36 publications

References 56 publications

Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping

Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping

For veterans with mild traumatic brain injury, improved posttraumatic stress disorder severity and sleep correlated with symptomatic improvement

An integrated model of chronic trauma‐induced insomnia

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