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Clinical Sleep Disorder Profiles in a Large Sample of Trauma Survivors: An Interdisciplinary View of Posttraumatic Sleep Disturbance
Barry Krakow, M.D., Patricia L. Haynes, Ph.D., Teddy D. Warner, Ph.D., Dominic Melendrez, B.S., R.P.S.G.T., Brandy N. Sisley, B.A., R.P.S.G.T. Lisa Johnston, Ph.D., Michael Hollifield, M.D., and Samuel Lee, B.A.
Study Objectives: To examine the relationship between psychiatric symptoms and self-reported sleep, sleepiness, and nightmare complaints in a convenience sample of 437 trauma survivors.
Method: Based on symptom severity reports, individuals were classified as having psychophysiological insomnia (PPI), chronic nightmare disorder (CND), and sleepdisordered
breathing (SDB) profiles. Individuals with each symptom profile were compared to individuals without the respective profile on sleep indices, sleepiness-related impairment, and psychiatric distress (anxiety, depression, posttraumatic stress symptoms).
Results: Individuals with PPI (76%), CND (79%), SDB (68%), or all three profiles (46%) had significantly worse sleep onset latency, sleep efficiency, total sleep time, sleep-related functional impairment, and psychiatric distress compared to those without each disorder profile.
Conclusions: The majority of trauma survivors in this sample suffered from sleep complaints sufficiently severe to warrant independent clinical attention by sleep
medicine specialists. Longitudinal studies are necessary to determine whether these disturbances are caused exclusively by PTSD or another sleep disorder comorbid with
PTSD.
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