title: Sleep disruptions among returning combat veterans from Iraq and Afghanistan.
abstract: BACKGROUND
  Post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) are common injuries among returning combat veterans from the wars in Iraq and Afghanistan. Although these combat injuries have been associated with increased sleep disruption, little is known about the nature and specificity of sleep problems within these common injury categories.
  
  
  METHODS
  A retrospective chart review of 69 consecutive referrals to the Waiter Reed Army Medical Center sleep clinic was conducted. All cases were active duty soldiers who had recently returned from combat deployment in Iraq or Afghanistan. Data from polysomnographically (PSG) recorded sleep stages, sleepiness scales, and documented medical diagnoses were extracted from medical records. Sleep data were compared across diagnoses of PTSD, TBI, and other clinical conditions.
  
  
  RESULTS
  As expected, clinical sleep disturbances, including rates of obstructive sleep apnea, excessive awakenings, daytime sleepiness, and hypoxia, were high for the sample as a whole. However, no differences across diagnostic groups were found. Differences were observed, however, on PSG measures of sleep quality, suggesting more frequent arousals from sleep among patients with PTSD and greater slow wave sleep among those with TBI. Except for REM latency, medication status had virtually no effect on sleep variables.
  
  
  CONCLUSIONS
  Among recently redeployed combat veterans, clinically significant sleep disturbances and problems with sleep-disordered breathing are common but nonspecific findings across primary diagnoses of PTSD, TBI, major depression, and anxiety disorder, whereas more subtle differences in sleep architecture and arousals as measured by overnight PSG recordings were modestly, but significantly, effective at distinguishing among the diagnostic groups.
authors: Walter Reed Army Medical Center, 6900 Georgia Avenue, NW, Washington, DC 20307, USA.
authors: Vincent F
authors: VF
authors: Capaldi
authors: Melanie L
authors: ML
authors: Guerrero
authors: William D S
authors: WD
authors: Killgore
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000453:epidemiology*; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008875:Middle Aged; D008889:Military Personnel; D017286:Polysomnography; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult