title: Sleep variability in military-related PTSD: a comparison to primary insomnia and healthy controls.
abstract: Sleep disturbances are prevalent in posttraumatic stress disorder (PTSD) and are associated with a number of adverse health consequences. Few studies have used comprehensive assessment methods to characterize sleep in Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn (OEF/OIF/OND) veterans with PTSD. OEF/OIF/OND veterans with PTSD and sleep disturbance (n = 45) were compared to patients with primary insomnia (n = 25) and healthy control subjects (n = 27). Participants were assessed using questionnaire-based measures as well as daily subjective and objective measures of sleep. The 3 groups were compared with regard to (a) group means, (b) intraindividual (i.e., night-to-night) variability of sleep, and (c) interindividual (i.e., within-group) variability of sleep. In terms of group means, only objective sleep efficiency was significantly worse with PTSD than with primary insomnia (d = 0.54). Those with PTSD differed from those with primary insomnia on measures of intraindividual as well as interindividual variability (d = 0.48-0.73). These results suggested sleep symptoms in OEF/OIF/OND veterans with PTSD are more variable across nights and less consistent across patients relative to sleep symptoms in insomnia patients without PTSD. These findings have implications for research, as well as for personalizing treatment for individuals with PTSD.
authors: San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA; Veterans Affairs San Diego Healthcare System, Research Service, San Diego, California, USA.
authors: Laura D
authors: LD
authors: Straus
authors: Sean P A
authors: SP
authors: Drummond
authors: Carla M
authors: CM
authors: Nappi
authors: Melissa M
authors: MM
authors: Jenkins
authors: Sonya B
authors: SB
authors: Norman
mesh_terms: D056044:Actigraphy; D000328:Adult; D055826:Afghan Campaign 2001-; D016022:Case-Control Studies; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000503:physiopathology*; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D014728:Veterans / Q000523:psychology*; D055815:Young Adult
references: Mil Med. 2010 Oct;175(10):759-62
references: 20968266
references: Am J Psychiatry. 1998 Jul;155(7):929-33
references: 9659859
references: Sleep. 1999 May 1;22 Suppl 2:S379-85
references: 10394611
references: Sleep. 2011 Apr 01;34(4):531-9
references: 21461332
references: J Anxiety Disord. 2005;19(2):233-44
references: 15533706
references: Sleep. 2012 Feb 01;35(2):287-302
references: 22294820
references: Sleep. 2011 May 01;34(5):601-8
references: 21532953
references: Compr Psychiatry. 2000 Nov-Dec;41(6):469-78
references: 11086154
references: Mil Med. 2008 Mar;173(3):230-5
references: 18419023
references: Sleep. 2006 Mar;29(3):299-305
references: 16553015
references: Sleep. 2007 Oct;30(10):1317-24
references: 17969465
references: Sleep Med. 2012 Apr;13(4):378-84
references: 22437142
references: Am J Psychiatry. 1995 Jan;152(1):110-5
references: 7802100
references: J Trauma Stress. 1995 Jan;8(1):75-90
references: 7712061
references: Sleep Med Rev. 2008 Jun;12(3):169-84
references: 18424196
references: Sleep. 2002 Sep 15;25(6):625-9
references: 12224841
references: Sleep Med. 2010 Jan;11(1):56-64
references: 19962939
references: Behav Sleep Med. 2013;11(4):258-74
references: 23205531
references: Sleep. 2014 Feb 01;37(2):327-41
references: 24497661
references: Psychiatry Res. 1989 May;28(2):193-213
references: 2748771
references: Sleep Med. 2012 May;13(5):469-75
references: 22357064
references: Sleep. 2008 Aug;31(8):1097-101
references: 18714781
references: Am J Psychiatry. 2000 May;157(5):669-82
references: 10784456
references: Depress Anxiety. 2011 Jul;28(7):596-606
references: 21681864
references: Depress Anxiety. 2001;13(3):132-56
references: 11387733
references: Sleep. 2013 Jul 1;36(7):1019-1025
references: 23814338