title: Sleep disturbance immediately prior to trauma predicts subsequent psychiatric disorder.
abstract: OBJECTIVE
  This study investigated the extent to which sleep disturbance in the period immediately prior to a traumatic event predicted development of subsequent psychiatric disorder.
  
  
  METHODS
  Prospective design cohort study.
  
  
  METHODS
  Four major trauma hospitals across Australia.
  
  
  METHODS
  A total of 1033 traumatically injured patients were initially assessed during hospital admission and followed up at 3 months (898) after injury.
  
  
  METHODS
  Lifetime psychiatric disorder was assessed in hospital with the Mini-International Neuropsychiatric Interview. Sleep disturbance in the 2 weeks prior to injury was also assessed using the Sleep Impairment Index. The prevalence of psychiatric disorder was assessed 3 months after traumatic injury.
  
  
  RESULTS
  There were 255 (28%) patients with a psychiatric disorder at 3 months. Patients who displayed sleep disturbance prior to the injury were more likely to develop a psychiatric disorder at 3 months (odds ratio: 2.44, 95% CI: 1.62-3.69). In terms of patients who had never experienced a prior disorder (n = 324), 96 patients (30%) had a psychiatric disorder at 3 months, and these patients were more likely to develop disorder if they displayed prior sleep disturbance (odds ratio: 3.16, 95% CI: 1.59-4.75).
  
  
  CONCLUSIONS
  These findings provide evidence that sleep disturbance prior to a traumatic event is a risk factor for development of posttraumatic psychiatric disorder.
authors.affiliation: University of New South Wales, Sydney, Australia. r.bryant@unsw.edu.au
authors.forename: Richard A
authors.initials: RA
authors.lastname: Bryant
authors.forename: Mark
authors.initials: M
authors.lastname: Creamer
authors.forename: Meaghan
authors.initials: M
authors.lastname: O'Donnell
authors.forename: Derrick
authors.initials: D
authors.lastname: Silove
authors.forename: Alexander C
authors.initials: AC
authors.lastname: McFarlane
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult