title: Nightmares, insomnia, and sleep-disordered breathing in fire evacuees seeking treatment for posttraumatic sleep disturbance.
abstract: Eight months after the Cerro Grande Fire, 78 evacuees seeking treatment for posttraumatic sleep disturbances were assessed for chronic nightmares, psychophysiological insomnia, and sleep-disordered breathing symptoms. Within this sample, 50% of participants were tested objectively for sleep-disordered breathing; 95% of those tested screened positive for sleep-disordered breathing. Multiple regression analyses demonstrated that these three sleep disorders accounted for 37% of the variance in posttraumatic stress symptoms, and each sleep disorder was significantly and independently associated with posttraumatic stress symptoms severity. The only systematic variable associated with posttraumatic stress symptoms of avoidance was sleep-disordered breathing. The findings suggest that three common sleep disorders relate to posttraumatic stress symptoms in a more complex manner than explained by the prevailing psychiatric paradigm, which conceptualizes sleep disturbances in PTSD merely as secondary symptoms of psychiatric distress.
authors.affiliation: Sleep & Human Health Institute, 6739 Academy NE, Suite 380, Albuquerque, New Mexico 87109, USA. bkrakow@sleeptreatment.com
authors.forename: Barry
authors.initials: B
authors.lastname: Krakow
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Haynes
authors.forename: Teddy D
authors.initials: TD
authors.lastname: Warner
authors.forename: Erin
authors.initials: E
authors.lastname: Santana
authors.forename: Dominic
authors.initials: D
authors.lastname: Melendrez
authors.forename: Lisa
authors.initials: L
authors.lastname: Johnston
authors.forename: Michael
authors.initials: M
authors.lastname: Hollifield
authors.forename: Brandy N
authors.initials: BN
authors.lastname: Sisley
authors.forename: Mary
authors.initials: M
authors.lastname: Koss
authors.forename: Laura
authors.initials: L
authors.lastname: Shafer
mesh_terms: D000328:Adult; D004325:Dreams / Q000523:psychology*; D005260:Female; D005390:Fires; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012891:Sleep Apnea Syndromes / Q000209:etiology; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology* / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology*