Sleep breathing and sleep movement disorders masquerading as insomnia in sexual-assault survivors.
A descriptive, hypothesis-generating study was performed with 156 female sexual-assault survivors who suffered from insomnia, nightmares, and posttraumatic stress disorder (PTSD). They completed 2 self-report sleep questionnaires to assess the potential presence of intrinsic sleep disorders. Seventy-seven percent of the sample (120 of 156) endorsed additional sleep complaints, besides their insomnia symptoms, that indicate the potential presence of sleep-disordered breathing ([SDB] 81 of 156, 52%) and sleep-related movement disorders ([SMD] 94 of 156, 60%). The potential for SDB was strongly correlated with the body mass index (BMI), an increase in arousal symptoms, and greater total PTSD severity. In some sexual-assault survivors, the relationship between sleeplessness and posttraumatic stress may be caused or exacerbated by intrinsic sleep disorders, and not be solely a function of psychophysiological insomnia--the traditional diagnostic term usually offered to explain the sleep problems associated with PTSD. Prevalence studies that use objective diagnostic evaluations such as polysomnography (PSG) are needed to test these hypotheses.
Krakow
B
B
Department of Emergency Medicine, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA.
Germain
A
A
Tandberg
D
D
Koss
M
M
Schrader
R
R
Hollifield
M
M
Cheng
D
D
Edmond
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D000704:Analysis of Variance; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D020189:Nocturnal Myoclonus Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D012494:Sampling Studies; D012742:Sex Offenses / Q000523:psychology*; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data