Late Breaking News
Another Promising Treatment (con't)
- Categorized in: 2013 Issues, Department of Defense (DoD), Department of Veterans Affairs (VA), PTSD, September 2013, Sleep, TBI
An additional study, which appeared in this summer in the journal SLEEP, provided even stronger evidence that managing sleep symptoms could be an effective way to control PTSD.
The research from the Naval Health Research Center, San Diego, CA, and the University of Pennsylvania Perelman School of Medicine in Philadelphia suggests that military servicemembers who suffer from insomnia prior to deployment might be at greater risk of developing PTSD, depression and anxiety once they return home. 2
In fact, pre-existing insomnia symptoms were found to be almost as great a risk as combat exposure for those mental disorders.
“Understanding environmental and behavioral risk factors associated with the onset of common major mental disorders is of great importance in a military occupational setting,” said lead author Philip Gehrman, PhD, a psychologist at the Philadelphia VAMC and an assistant professor of psychology at Penn.
“This study is the first prospective investigation of the relationship between sleep disturbance and development of newly identified positive screens for mental disorders in a large military cohort who have been deployed in support of the recent operations in Iraq or Afghanistan,” he said.
Researchers used self-reported data from the Millennium Cohort Study to evaluate the association of pre-deployment sleep duration and insomnia symptoms on the development of new-onset mental disorders among 15,204 returning servicemembers. The Millennium Cohort Study is funded through the Military Operational Medicine Research Program of the US Army Medical Research and Materiel Command, Fort Detrick, MD.
Investigators then calculated the odds that the military personnel studied, who represented all branches of service, would develop PTSD, depression and anxiety, while adjusting for relevant covariates including combat-related trauma.
Identified following deployment were 522 servicemembers and veterans with new-onset PTSD, 151 with anxiety, and 303 with depression.
Pre-deployment insomnia symptoms, as well as combat-related trauma, were significantly associated with higher odds of developing PTSD, , depression and anxiety.
“One of the more interesting findings of this study is not only the degree of risk conferred by pre-deployment insomnia symptoms, but also the relative magnitude of this risk compared with combat-related trauma,” Gehrman pointed out. “The risk conferred by insomnia symptoms was almost as strong as our measure of combat exposure in adjusted models.”
Short sleep duration, less than six hours of sleep per night, was associated with new-onset PTSD symptoms. Earlier this year, researchers from the Madigan Army Medical Center in Tacoma, WA, reported that the self-reported sleep duration for a large cohort of servicemembers seeking help for sleep problems was only 5.74 hours per night. 3
"We found that insomnia is both a symptom and a risk factor for mental illness and may present a modifiable target for intervention among military personnel,” Gehrman suggested. “We hope that by early identification of those most vulnerable, the potential exists for the designing and testing of preventive strategies that may reduce the occurrence of PTSD, anxiety and depression.”
Study authors called for additional studies to investigate whether routine inquiry about insomnia symptoms and use of appropriate early, effective interventions could reduce subsequent morbidity from mental disorders. One way to do that, they suggested, was to incorporate that screening into routine pre-deployment testing.
1. Tamanna, S, et al. (2013, June). Effect of Continuous Positive Airway Pressure (CPAP) Therapy on Nightmares in Patients with Post-traumatic Stress Disorder and Obstructive Sleep Apnea. Presented at the SLEEP 2013 meeting, Baltimore, MD.
2. Gehrman P; Seelig AD; Jacobson IG; Boyko EJ; Hooper TI; Gackstetter GD; Ulmer CS; Smith TC; for the Millennium Cohort Study Team. Predeployment sleep duration and insomnia symptoms as risk factors for new-onset mental health disorders following military deployment. SLEEP 2013;36(7):1009-1018.
3. Mysliwiec V, McGraw L, Pierce R, Smith P, Trapp B, Roth BJ. Sleep disorders and associated medical comorbidities in active duty military personnel. Sleep. 2013 Feb 1;36(2):167-74. doi: 10.5665/sleep.2364. PubMed PMID: 23372263; PubMed Central PMCID: PMC3543057