title: Subjective sleep disturbance in veterans receiving care in the Veterans Affairs Polytrauma System following blast-related mild traumatic brain injury.
abstract: OBJECTIVE
  This investigation sought to characterize prevalence and factors associated with subjective sleep disturbance (SSD) in a clinical sample of veterans with blast-related mild traumatic brain injury (mTBI).
  
  
  METHODS
  Adult veterans with history of blast-related mTBI were enrolled in a cross-sectional study. Data on demographics, injury, and current symptoms, including SSD, were obtained. Descriptive and univariate analyses investigated prevalence of SSD and associated factors.
  
  
  RESULTS
  Participants were 114 veterans with blast-related mTBI (96% male; mean age = 31 years, SD = 8; mean number of days since injury =1,044, SD = 538). 78% screened positive for post-traumatic stress disorder and 77% reported SSD. Loss of consciousness at time of injury, current nightmares, depression, headache, fatigue, and positive screen for post-traumatic stress disorder were significantly associated with SSD (p < 0.05).
  
  
  CONCLUSIONS
  SSD was pervasive in this clinical sample and was significantly associated with multiple modifiable emotional symptoms as well as headache and fatigue; this is consistent with previous literature including samples with history of nonblast-related mTBI. Future research incorporating objective measurement of SSD and associated symptoms is needed to inform evidence-based screening, assessment, and treatment efforts for veterans with history of mTBI.
authors.affiliation: Hunter Holmes McGuire Veterans Affairs Medical Center, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA.
authors.forename: Leah
authors.initials: L
authors.lastname: Farrell-Carnahan
authors.forename: Laura
authors.initials: L
authors.lastname: Franke
authors.forename: Carolyn
authors.initials: C
authors.lastname: Graham
authors.forename: Shane
authors.initials: S
authors.lastname: McNamee
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000453:epidemiology*; D001930:Brain Injuries / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004325:Dreams / Q000523:psychology; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006261:Headache / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014728:Veterans / Q000523:psychology*; D055815:Young Adult