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

Abstract

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.

Relation between coping and posttrauma cognitions on PTSD in a combat-trauma population

“…For the present study, data was used from those participants who had a history of a Criterion A combat trauma event during OIF/OEF/OND deployment, assessed as part of the clinical interview with the Life Events Checklist (LEC; Gray, Litz, Hsu, & Lombardo, 2004) and who met certain criteria (described in the Measures section) as part of the Clinician Administered PTSD Scale (CAPS) DSM-IV version (Blake et al, 1995). To date, published work from this study has examined the relationship between PTSD and disturbed sleep (Lind et al, 2017), and additional work under review has examined anxiety sensitivity and distress tolerance. Thus, the current work is the first from this study to examine negative cognitions and their interplay with coping behaviors on PTSD.…”

Longitudinal Associations between Sleep, Intrusive Thoughts, and Alcohol Problems Among Veterans

“…Individuals with PTSD experience more arousals from sleep (Capaldi et al., ), sleep for shorter amounts of time (Seelig et al., ), and report worse quality sleep (King et al., ; Lind et al., ) than those without PTSD. Indeed, trouble falling or staying asleep is the most commonly reported symptom of PTSD after deployment (McLay et al., ) and persists following effective treatment of PTSD (Zayfert and Deviva, ).…”

Sleep problems contribute to post-concussive symptoms in service members with a history of mild traumatic brain injury without posttraumatic stress disorder or major depressive disorder

“…Sleep problems are common symptoms of stress-related and mood disorders; in fact sleep disturbance is part of the symptom criteria for both PTSD and MDD, but studies on mild TBI and sleep often do not control for mental health co-morbidities (Gosselin et al., 2009; Williams et al., 2008). Among Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) veterans, those with PTSD reported worse sleep than trauma-exposed controls (Lind et al., 2017), and controlling for PTSD symptoms removed the reported sleep difference between PTSD only and PTSD + TBI groups, suggesting that greater PTSD symptoms drove the higher scores in the PTSD + TBI comorbid group (DeGutis et al., 2018). A longitudinal study of change in sleep over time among OEF/OIF veterans with PTSD showed that nightmares increased over time although overall sleep complaints decreased (King, Donnelly, Warner, Wade, & Pigeon, 2017).…”