title: Prevalence and Mental Health Correlates of Insomnia in First-Encounter Veterans with and without Military Sexual Trauma.
abstract: OBJECTIVE
  There is limited information about prevalence of insomnia in general populations of veterans of recent wars in Iraq and Afghanistan. No studies have examined insomnia in veterans with military sexual trauma (MST). We assess prevalence of insomnia, identify types of services sought by veterans with insomnia, and examine correlates of insomnia in veterans with and without MST.
  
  
  METHODS
  A cross-sectional study of first-encounter veterans registering to establish care.
  
  
  METHODS
  Veteran Affairs San Diego Healthcare System.
  
  
  METHODS
  Nine hundred seventeen veterans completed questionnaires assessing insomnia, MST, service needs, traumatic brain injury, resilience, and symptoms of depression, posttraumatic stress disorder (PTSD), pain, alcohol misuse, and hypomania.
  
  
  METHODS
  N/A.
  
  
  RESULTS
  53.1% of veterans without MST and 60.8% of veterans with MST had clinically significant insomnia symptoms, with the MST subsample reporting more severe symptoms, P < 0.05. Insomnia was more prevalent than depression, hypomania, PTSD, and substance misuse. Veterans with insomnia were more likely to seek care for physical health problems and primary care versus mental health concerns, P < 0.001. For the veteran sample without MST, age, combat service, traumatic brain injury, pain, and depression were associated with worse insomnia, P < 0.001. For the MST subsample, employment status, pain, and depression were associated with worse insomnia, P < 0.001.
  
  
  CONCLUSIONS
  Study findings indicate a higher rate of insomnia in veterans compared to what has been found in the general population. Insomnia is more prevalent, and more severe, in veterans with military sexual trauma. Routine insomnia assessments and referrals to providers who can provide evidence-based treatment are crucial.
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA.|Research Service, VA San Diego Healthcare System, San Diego, CA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Jenkins
authors.affiliation: Psychology Services, VA San Diego Healthcare System, San Diego, CA.|Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Colvonen
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA.|Research Service, VA San Diego Healthcare System, San Diego, CA.|Psychology Services, VA San Diego Healthcare System, San Diego, CA.|Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA.|National Center for PTSD, White River Junction, VT.
authors.forename: Sonya B
authors.initials: SB
authors.lastname: Norman
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA.|Psychology Services, VA San Diego Healthcare System, San Diego, CA.|Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA.
authors.forename: Niloofar
authors.initials: N
authors.lastname: Afari
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA.|Psychology Services, VA San Diego Healthcare System, San Diego, CA.|Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA.
authors.forename: Carolyn B
authors.initials: CB
authors.lastname: Allard
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA.|Psychology Services, VA San Diego Healthcare System, San Diego, CA.|Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA.|School of Psychological Sciences, Monash University, Clayton, VIC, Australia.
authors.forename: Sean P A
authors.initials: SP
authors.lastname: Drummond
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008889:Military Personnel / Q000523:psychology; D010146:Pain / Q000453:epidemiology; D015995:Prevalence; D000067073:Psychological Trauma / Q000453:epidemiology / Q000523:psychology; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data*; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: insomnia; military sexual trauma; prevalence; veterans