Sleep difficulties and alcohol use motives in female rape victims with posttraumatic stress disorder

Nishith, Pallavi; Resick, Patricia A.; Mueser, Kim T.

doi:10.1023/a:1011152405048

Cited by 124 publications

(92 citation statements)

References 31 publications

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“…42 Despite this, disturbed sleep has been associated with drinking (or using cannabis) to cope in veterans with PTSD. 43,44 Given this literature, along with established relationships between substance use disorders themselves and disturbed sleep, 45 it is not surprising that our study found an association between substance use coping and sleep. However, it is interesting that this association remained even beyond the effects of PTSD, suggesting that substance use coping contributes uniquely to the variance in disturbed sleep across all veterans.…”

Section: Discussionsupporting

confidence: 51%

Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping

Lind

Brown

Farrell-Carnahan

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: 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.

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Section: Discussionsupporting

confidence: 51%

Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping

Lind

Brown

Farrell-Carnahan

et al. 2017

Journal of Clinical Sleep Medicine

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“…Compared to patients without sleep complaints, PTSD patients with sleep disorders experience an increased severity of depression, 2 suicidality, 2 psychiatric distress, 3 poor quality of life and functioning, 3 poorer perceived physical health, 4 and substance abuse. [5][6][7] Obstructive sleep apnea (OSA) is common among patients with underlying psychiatric conditions. The prevalence of OSA is higher among patients with PTSD than the general population.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

The Impact of Posttraumatic Stress Disorder on CPAP Adherence in Patients with Obstructive Sleep Apnea

Collen

Lettieri

Hoffman

2012

Journal of Clinical Sleep Medicine

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Introduction:Obstructive sleep apnea (OSA) is a common comorbid condition in patients with posttraumatic stress disorder (PTSD); insuffi ciently treated OSA may adversely impact outcomes. Sleep fragmentation and insomnia are common in PTSD and may impair CPAP adherence. We sought to determine the impact of combat-related PTSD on CPAP adherence in soldiers. Methods: Retrospective case-control study. Objective measures of CPAP use were compared between OSA patients with and without PTSD. Groups were matched for age, BMI, and apnea-hypopnea index (AHI). Results: We included 90 patients (45 Control, 45 PTSD). Among the cohort, mean age was 39.9 ± 11.2, mean BMI 27.9 ± 8.0, mean ESS 13.6 ± 5.7, and mean AHI 28.2 ± 22.4. There was a trend towards a higher rate of comorbid insomnia among patients with PTSD (25.8% vs. 11.1%, p = 0.10). PTSD was associated with signifi cantly less use of CPAP. Specifi cally, CPAP was used on 61.4% ± 22.2% of nights in PTSD patients compared with 76.8% ± 16.4% in patients without PTSD (p = 0.001). Mean nightly use of CPAP was 3.4 ± 1.2 h in the PTSD group compared with 4.7 ± 2.2 h among controls (p < 0.001). Regular use of CPAP (> 4 h per night for > 70% of nights) was also lower among PTSD patients (25.2% vs. 58.3%, p = 0.01). Conclusion: Among soldiers with OSA, comorbid PTSD was associated with signifi cantly decreased CPAP adherence. Given the potential for adverse clinical outcomes, resolution of poor sleep quality should be prioritized in the treatment of PTSD and potential barriers to CPAP adherence should be overcome in patients with comorbid OSA. Keywords: Posttraumatic stress order, sleep apnea, obstructive sleep apnea, CPAP, CPAP compliance, CPAP adherence, sleep disordered breathing, deployment related sleep disorders Citation: Collen JF; Lettieri CJ; Hoffman M. The impact of posttraumatic stress disorder on CPAP adherence in patients with obstructive sleep apnea.

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“…In one of these studies, Epstein, Saunders, Kilpatrick, and Resnick (1998; but also see Nishith, Resick, & Mueser, 2001) found that posttraumatic stress symptomatology served as a mediator between childhood rape and alcohol use in adult women. The present study extends their findings by specifying emotion regulation processes that may explain the relationship between psychological distress and alcohol problems.…”

mentioning

confidence: 99%

Motives to drink as mediators between childhood sexual assault and alcohol problems in adult women

Grayson

Nolen–Hoeksema

2005

Journal of Traumatic Stress

163

137

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Two models are proposed to relate maladaptive emotion regulation strategies and alcohol-related problems for women with a history of childhood sexual assault (CSA). The distress coping model suggests only one motive-drinking to cope with negative emotions-mediates the relationship between CSA and alcohol problems. The emotion regulation model suggests two motives mediate the relationship between CSA and alcohol problems: drinking to cope with negative emotions and drinking to enhance positive emotions. These models were tested in a random community sample of 697 women, ranging from 25 to 75 years old. Both motives partially mediated the relationship between CSA and alcohol problems. Effects were small, but reliable.

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Sleep difficulties and alcohol use motives in female rape victims with posttraumatic stress disorder

Cited by 124 publications

References 31 publications

Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping

Sleep Disturbances in OEF/OIF/OND Veterans: Associations with PTSD, Personality, and Coping

The Impact of Posttraumatic Stress Disorder on CPAP Adherence in Patients with Obstructive Sleep Apnea

Motives to drink as mediators between childhood sexual assault and alcohol problems in adult women

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