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Nightmares, insomnia, and sleep-disordered breathing in fire evacuees seeking treatment for posttraumatic sleep disturbance

Sleep & Human Health Institute, 6739 Academy NE, Suite 380, Albuquerque, New Mexico 87109, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 07/2004; 17(3):257-68. DOI: 10.1023/B:JOTS.0000029269.29098.67
Source: PubMed

ABSTRACT Eight months after the Cerro Grande Fire, 78 evacuees seeking treatment for posttraumatic sleep disturbances were assessed for chronic nightmares, psychophysiological insomnia, and sleep-disordered breathing symptoms. Within this sample, 50% of participants were tested objectively for sleep-disordered breathing; 95% of those tested screened positive for sleep-disordered breathing. Multiple regression analyses demonstrated that these three sleep disorders accounted for 37% of the variance in posttraumatic stress symptoms, and each sleep disorder was significantly and independently associated with posttraumatic stress symptoms severity. The only systematic variable associated with posttraumatic stress symptoms of avoidance was sleep-disordered breathing. The findings suggest that three common sleep disorders relate to posttraumatic stress symptoms in a more complex manner than explained by the prevailing psychiatric paradigm, which conceptualizes sleep disturbances in PTSD merely as secondary symptoms of psychiatric distress.

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    • "In addition, utilizing a measure of sleep apnea will be important in future studies since this sleep disorder may contribute both to fatigue/lassitude and to psychological disorders like PTSD (Krakow et al., 2004). It would also be interesting to obtain objective measures of sleep disturbances (e.g., actigraphy and EEG) at baseline to see if these variables are related to increased risk for the development of internalizing disorders. "
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    ABSTRACT: There is growing evidence that disturbed sleep is a risk factor for the development of a number of psychiatric diagnoses including depression, PTSD and substance use. The goal of this study was to use a subset of participants from a larger prospective longitudinal study to examine whether preexisting daytime and nighttime sleep disturbances predict depression, PTSD and substance use in US National Guard Soldiers deployed to Iraq. Data on daytime and nighttime sleep complaints, baseline symptoms and personality variables were gathered prior to deployment to Iraq. Measures of psychopathology were collected at three time points post-deployment over the course of two years using both questionnaires and interviews. Multiple regressions were used to predict diagnoses and symptoms of depression, PTSD and substance use. Pre-deployment daytime and nighttime sleep complaints contributed significantly to the prediction of PTSD and depression up to two years after deployment, but not substance use. This study suggests that daytime and nighttime sleep complaints are a risk factor for internalizing disorders including PTSD and depression.
    Journal of anxiety disorders 07/2013; 27(5):512-519. DOI:10.1016/j.janxdis.2013.07.003 · 2.68 Impact Factor
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    • "Furthermore, 50Á70% of PTSD patients report recurrent nightmares (Kilpatrick et al., 1998; Leskin, Woodward, Young, & Sheikh, 2002; Neylan et al., 1998). Apart from those sleep disturbances listed in the clinical description of PTSD, periodic limb movements (PLMs) and sleep-disordered breathing (SDB) also often co-occur in PTSD patients: SDB has been found in 50Á90% of PTSD patients in different study populations (Krakow et al., 2001, 2002, 2004), and clinically significant increases in PLMs have been found in different PTSD populations of veterans and sexual assault survivors , compared to the non-PTSD control groups (Brown & Boudewyns, 1996; Krakow et al., 2000; Mellman, Kulick-Bell, Ashlock, & Nolan, 1995; Ross et al., 1994). "
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    European Journal of Psychotraumatology 04/2013; 4. DOI:10.3402/ejpt.v4i0.18714 · 2.40 Impact Factor
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    • "OSAS was not more prevalent in patients with PTSD compared to TCs and HCs, contrary to previous uncontrolled studies that suggested indices between 60 and 90% in PTSD (Krakow, Germain, et al., 2000; Krakow et al., 2004, 2006; Yesavage et al., 2010). "
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