Sleep complaints as early predictors of posttraumatic stress disorder: a 1-year prospective study of injured survivors of motor vehicle accidents.
OBJECTIVE
Disturbed sleep is a common complaint among patients with posttraumatic stress disorder (PTSD) that appears in the reexperiencing and hyperarousal symptom clusters in DSM-IV. The causal relationship between sleep complaints and PTSD is unclear.


METHODS
Self-reported insomnia and excessive daytime sleepiness were assessed in 102 victims of motor vehicle accidents and 19 comparison subjects 1 week and 1, 3, 6, and 12 months after the trauma. At 12 months the Structured Clinical Interview for DSM-III-R was administered to determine diagnoses of PTSD.


RESULTS
Twenty-six of the accident victims but none of the comparison subjects met the criteria for PTSD. Logistic regression models indicated that sleep complaints from 1 month on were significant in predicting PTSD at 1 year.


CONCLUSIONS
These results suggest that on the basis of sleep complaints as early as 1 month after the trauma, it is possible to detect subjects who will later develop chronic PTSD.
Koren
Danny
D
Department of Psychiatry, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa.
Arnon
Isaac
I
Lavie
Peretz
P
Klein
Ehud
E
D000063:Accidents, Traffic / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D017741:Survivors / Q000523:psychology*; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology*