Sleep Disorders Common Among Soldiers With Combat-Related Post-traumatic Stress Disorder
Poor sleep quality, insomnia,sleep apnea, and daytime somnolence are common among recently deployed Soldiers and those with Post Traumatic Stress Disorder. We sought to determine the prevalence of sleep complaints and sleep disorders among recently deployed Soldiers with PTSD.
The researchers analyzed the records of 80 consecutive Soldiers returning from combat and diagnosed with PTSD. We determined the rate of sleep complaints and prevalence of insomnia and obstructive sleep apnea. We compared demographic data, psychoactive medication use, psychiatric disorders and concomitant traumatic brain injury (TBI) to determine if any variables correlated with increased sleep complaints or disorders.
80 consecutive patients were included. 89.6% were men (mean age 37.7±0.3 years, mean BMI 29.0±0.3 Kg/m2). 76.1% had depression and 30.1% had anxiety. 91% were taking psychoactive medications (average 3.9 Rx/patient). 92.5% reported sleep complaints (46.8% difficulty falling asleep, 35.8% nocturnal awakenings).
Insomnia was diagnosed in 52.8%. Mean ESS was 10.5±0.5. 72% underwent polysomnography (mean sleep latency 17.8±6.6 minutes, mean sleep efficiency 84.5±9.2%). Sleep fragmentation was common (mean arousal index 27.7±2.6 events/hour). 61% were diagnosed with OSA (mean AHI 21.8±3.3 events/hour).
Those with OSA had less use of narcotics and benzodiazepines and a lower prevalence of TBI than those without OSA.TBI occurred in 50.7%, equally divided among blast and blunt mechanism. TBI was associated with more sleep fragmentation and insomnia, but less OSA, sleepiness and depression than those without TBI. Blast injuries were more significantly associated with insomnia, sleep fragmentation and anxiety, while blunt trauma led to more somnolence and OSA.
Sleep complaints were almost universal among Soldiers with PTSD. The majority were diagnosed with insomnia and/or OSA. While most were taking psychoactive medications that can disrupt sleep or cause somnolence, the only variable that increased the presence of sleep disorders was concomitant TBI, with type of sleep disturbance differing based on mechanism of injury.
Given the common occurrence of sleep complaints and their potential clinical impact, patients with PTSD should be screened for sleep disorders.
Source : doi:10.1378/chest.10975
(Chest. 2010; 138:704A)
Tagged with: Anxiety • Daytime Sleepiness • daytime somnolence • depression • Insomnia • Obstructive Sleep Apnea • OSA • Polysomnography • poor sleep • post traumatic stress disorder • PTSD • Sleep Apnea • Sleep Disorders • sleep fragmentation • Soldiers
Filed under: Anxiety • Clinical Research • Daytime Sleepiness • Depression • Insomnia • Obstructive Sleep Apnea • Other Disorders • Sleep • Sleep Apnea • Sleep Apnea Effects • Sleep Apnea News • Sleep Apnea Research • Sleep Deprivation • Sleep Disordered Breathing • Sleep Disorders • Sleep Problems • Stress
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I take medications for severe anxiety and panic attacks but I am in no way going to say that , that is the only way. I am hoping to get off the meds and go natural myself eventually. I will say that I know that Cognitive Behavioral Therapy has helped me more than anything. You need to get to the root of what is causing your panic attacks. Medications for anxiety do not take away panic, they only take the edge off while you are learning new ways to cope and therefor stop having the panic attacks. It has been shown that medication in conjunction with therapy is the best form of treatment, even if holistic or natural and the medication does not have to be taken for a long period of time necessarily but definitely needs to be prescribed by a Dr. even if you prefer to go the Holistic route. I wish you the best as I know how scary panic attacks can be~
My experience is nothing like as extreme as a combat generated one. My RTA about 43 years ago resulted in a concussion ( sideways whiplash) which meant a four day stay in hospital, until I properly came round and the guilt of serious injury to my best friend, a passenger in the RTA. Though a ‘no fault’ collision due to a tyre deflation and resulting impact at 80 mph approximately, the symptoms persist. There was physical trauma to my neck which may have led to Mild sleep Apnoea in later life, or this could be co- related , to a Stroke (TIA) suffered two years ago in May 2009. The apneoa, long undiagnosed will have got worse due to ageing, or the Stroke may have had the apneoa as an increased risk factor input or equally have made the apneoa’s worse ( The consultants opening gambit). In the abscence of overwight, smoking or alcohol abuse, and a familial history of snoring it is difficult to say.
But hey, what does it take to ask , Do you snore loudly and gasp, gulp or gurgle and are you tired despite having a full night, apparently asleep. This should trigger polysomnography, including EEG for sleep stage if possible, then we are cooking with gas and using preventative medicine. Not this patch up/ piecemeal, after the event way that seems prevalent now. It took 5 months for me to get CPAP thru NHS or two and a half years if my visit to my GP reporting severe snoring and daytime sleepiness had been acted on, or lifelong if my snoring had been regarded as a need to ask the daytime sleepiness question. The repeated comments from many employers that I was performing at about 60 % caused me to ask the question Why? which finally got action. Reductionist Descartes you have a lot to answer for as well as a lot of good done! Roger D