TAMPA, FL – Anger is a major contributor to sleep problems among military servicemembers with post-traumatic stress disorder.

A study in the Journal of Clinical Sleep Medicine sought to characterize associations between sleep impairments and posttraumatic stress disorder (PTSD) symptoms, including anger, in service members seeking treatment for PTSD.1

The study was led by researchers from the James A. Haley Veterans’ Hospital in Tampa, Fl, but also included participation from the South Texas Veterans Health System in San Antonio, the VA Boston Healthcare System, the Carl R. Darnall Army Medical Center at Fort Hood, TX, and several academic institutions. Researchers recruited 93 US Army personnel into a PTSD treatment study and participants completed a baseline assessment.

They were assessed for the following:

  1. retrospective, self-reported insomnia,
  2. prospective sleep diaries assessing sleep patterns and nightmares, and
  3. polysomnography (PSG) measured sleep architecture and obstructive sleep apnea-hypopnea (OSAH) severity.

The authors reported that all participants met PTSD, insomnia, and nightmare diagnostic criteria. Their mean sleep efficiency was 70%, and their total sleep time was 5.5 hours. Researchers determined that obstructive sleep apnea/hypopnea (OSAH index ≥ 5), 53%, and clinically significant anger, 85%, were significant factors.

“PTSD severity was associated with insomnia severity (β =.58), nightmare severity (β = .24), nightmare frequency (β = .31), and time spent in Stage 1 sleep (β = .27, all p < .05). Anger severity was associated with insomnia severity (β =37), nightmare severity (β = .28), and OSAH during rapid eye movement (β = .31, all p < .05),” they noted.

The study concluded that insomnia and nightmares were related to PTSD and anger severity, and OSAH was related to anger. “Better assessment and evidence-based treatment of these comorbid sleep impairments in service members with PTSD and significant anger, should result in better PTSD, anger, and quality of life outcomes,” the authors suggested.

 

  1. Miles SR, Pruiksma KE, Slavish D, Dietch JR, et. al. Sleep disorder symptoms are associated with greater posttraumatic stress and anger symptoms in U.S. army service members seeking treatment for PTSD. J Clin Sleep Med. 2022 Feb 25. doi: 10.5664/jcsm.9926. Epub ahead of print. PMID: 35197191.