title: Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping.
abstract: OBJECTIVE
  Sleep disturbances are well documented in relation to trauma exposure and posttraumatic stress disorder (PTSD), but correlates of such disturbances remain understudied in veteran populations. We conducted a preliminary study of sleep disturbances in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (n = 133; mean [standard deviation] age = 29.8 [4.7] y).
  
  
  METHODS
  Veterans were assigned to one of three groups based on responses to the Clinician Administered PTSD Scale: control (no trauma-exposure [TE] or PTSD), TE, and PTSD. Sleep disturbance was assessed using the Pittsburgh Sleep Quality Index (PSQI). Measures of resilience, trauma load, personality, coping, alcohol use, and mild traumatic brain injury were also assessed via self-report.
  
  
  RESULTS
  The PTSD group had significantly more disturbed sleep (PSQI global score mean = 8.94, standard deviation = 3.12) than control (mean = 5.27, standard deviation = 3.23) and TE (mean = 5.34, standard deviation = 3.17) groups, but there were no differences between TE and control. The same pattern emerged across most PSQI subscales. Results of linear regression analyses indicated that current smoking, Army (versus other military branches), neuroticism, and using substances to cope were all significant correlates of higher sleep disturbance, whereas post-deployment social support was associated with less sleep disturbance. However, when combined together into a model with PTSD status, only neuroticism and substance use coping remained significant as predictors of more disturbed sleep.
  
  
  CONCLUSIONS
  These initial findings suggest that TE itself may not be an independent risk factor for disturbed sleep in veterans, and that neurotic personality and a tendency to cope by using substances may partially explain sleep disturbance, above and beyond a diagnosis of PTSD.
authors.affiliation: Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA.
authors.forename: Mackenzie J
authors.initials: MJ
authors.lastname: Lind
authors.affiliation: Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA.
authors.forename: Emily
authors.initials: E
authors.lastname: Brown
authors.affiliation: Hunter Holmes McGuire VA Medical Center, Richmond, VA.
authors.forename: Leah
authors.initials: L
authors.lastname: Farrell-Carnahan
authors.affiliation: Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA.
authors.forename: Ruth C
authors.initials: RC
authors.lastname: Brown
authors.affiliation: Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA.|Department of Psychology, Virginia Commonwealth University, Richmond, VA.
authors.forename: Sage
authors.initials: S
authors.lastname: Hawn
authors.affiliation: Department of Pediatrics, University of Virginia, Charlottesville, VA.
authors.forename: Erin
authors.initials: E
authors.lastname: Berenz
authors.affiliation: Hunter Holmes McGuire VA Medical Center, Richmond, VA.|Department of Psychology, Virginia Commonwealth University, Richmond, VA.|Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA.
authors.forename: Scott
authors.initials: S
authors.lastname: McDonald
authors.affiliation: Hunter Holmes McGuire VA Medical Center, Richmond, VA.|Department of Psychology, Virginia Commonwealth University, Richmond, VA.|Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA.
authors.forename: Treven
authors.initials: T
authors.lastname: Pickett
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.
authors.forename: Carla Kmett
authors.initials: CK
authors.lastname: Danielson
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA.|Department of Psychology, Virginia Commonwealth University, Richmond, VA.
authors.forename: Ananda B
authors.initials: AB
authors.lastname: Amstadter
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D055826:Afghan Campaign 2001-; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D010551:Personality / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000150:complications* / Q000503:physiopathology; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014728:Veterans; D055815:Young Adult
keywords: PTSD; combat; coping; personality; sleep; trauma; veterans