title: Improved Sleep Quality is Associated with Reductions in Depression and PTSD Arousal Symptoms and Increases in IGF-1 Concentrations.
abstract: OBJECTIVE
  One-third of deployed military personnel will be diagnosed with insomnia, placing them at high risk for comorbid depression, posttraumatic stress disorder (PTSD), and medical conditions. The disruption of trophic factors has been implicated in these comorbid conditions, which can impede postdeployment recovery. This study determined if improved sleep quality is associated with (1) reductions in depression and posttraumatic symptoms, as well as enrichments in health-related quality of life (HRQOL), and (2) changes in plasma concentrations of brain derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1).
  
  
  METHODS
  Forty-four military personnel diagnosed with insomnia underwent clinical evaluations and blood draws at pretreatment and at posttreatment following cognitive behavioral therapy for insomnia and automatic positive airway pressure treatment. Participants were classified as sleep improved (n = 28) or sleep declined (n = 16) based on their change in pretreatment to posttreatment Pittsburgh Sleep Quality Index (PSQI) score. Both groups were compared on outcomes of depression, PTSD, HRQOL, BDNF, and IGF-1.
  
  
  RESULTS
  Paired t-tests of the sleep improved group revealed significant declines in depression (p = 0.005) and posttraumatic arousal (p = 0.006) symptoms, and a significant increase in concentrations of IGF-1 (p = 0.009). The sleep declined group had no relevant change in psychiatric symptoms or trophic factors, and had further declines on five of eight dimensions of HRQOL. Between-group change score differences were significant at p < 0.05.
  
  
  CONCLUSIONS
  These findings suggest that interventions, which successfully improve sleep quality, are an effective means to reduce the depression and posttraumatic arousal symptoms common to military personnel, as well as increase protective trophic factors implicated in these conditions.
authors.affiliation: National Institute of Nursing Research, National Institutes of Health, Bethesda, MD.|Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Rusch
authors.affiliation: National Institute of Nursing Research, National Institutes of Health, Bethesda, MD.
authors.forename: Pedro
authors.initials: P
authors.lastname: Guardado
authors.affiliation: Madigan Army Medical Center, Tacoma, WA.
authors.forename: Tristin
authors.initials: T
authors.lastname: Baxter
authors.affiliation: Madigan Army Medical Center, Tacoma, WA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mysliwiec
authors.affiliation: National Institute of Nursing Research, National Institutes of Health, Bethesda, MD.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Gill
mesh_terms: D000293:Adolescent; D000328:Adult; D001143:Arousal / Q000502:physiology; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood; D015897:Comorbidity; D003866:Depressive Disorder / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data; D012890:Sleep / Q000502:physiology; D007319:Sleep Initiation and Maintenance Disorders / Q000097:blood* / Q000453:epidemiology* / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D019208:Brain-Derived Neurotrophic Factor; D007334:Insulin-Like Growth Factor I; C579455:BDNF protein, human
keywords: BDNF; IGF-1; PTSD; depression; insomnia; mTBI; military; sleep quality; trauma