Resilience Laboratory, Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT 06516, USA.
J Psychosom Res. 2010 Nov;69(5):441-8. doi: 10.1016/j.jpsychores.2010.07.002. Epub 2010 Sep 21.
Sleep difficulties are common in individuals exposed to stress or trauma, and maladaptive cognitive coping strategies, such as worry and fear of losing vigilance, as well as low social support, may further impair sleep quality. This study examined the severity and correlates of sleep difficulties in a sample of treatment-seeking veterans of Operations Enduring Freedom and Iraqi Freedom (OEF-OIF).
A total of 167 OEF-OIF veterans seeking behavioral or primary care services completed a questionnaire containing measures of sleep quality, combat exposure, psychopathology, fear of loss of vigilance, cognitive coping strategies, and unit and postdeployment social support within 1 year of returning from deployment.
Mean Pittsburgh Sleep Quality Inventory scores in the full sample were indicative of severely impaired sleep. Posttraumatic stress disorder (PTSD) was associated with increased sleep difficulties, most notably sleep disturbances, daytime dysfunction, and sleep quality. Hierarchical regression analysis in the full sample revealed that PTSD symptoms and scores on measures of worry and fear of loss of vigilance were positively associated with sleep difficulties and that scores on a measure of unit member support were negatively associated with sleep difficulties. Among veterans with PTSD, fear of loss of vigilance was positively associated with sleep difficulties and cognitive distraction and unit member support were negatively associated with sleep difficulties.
Treatment-seeking OEF-OIF veterans report severe sleep difficulties, with more pronounced impairment in veterans with PTSD. The results of this study suggest that interventions to mitigate worry and fear of loss of vigilance and to enhance perceived unit member support may be helpful in reducing sleep difficulties following return from deployment in this population.
睡眠困难在经历压力或创伤的个体中很常见，适应不良的认知应对策略，如担忧和害怕失去警觉，以及低社会支持，可能进一步损害睡眠质量。本研究调查了在寻求治疗的持久自由行动和伊拉克自由行动（OEF-OIF）退伍军人样本中睡眠困难的严重程度和相关性。
共有 167 名寻求行为或初级保健服务的 OEF-OIF 退伍军人在部署后 1 年内完成了一份问卷，其中包含睡眠质量、战斗暴露、精神病理学、对失去警觉的恐惧、认知应对策略以及单位和部署后的社会支持的测量。
在整个样本中，匹兹堡睡眠质量指数的平均分数表明睡眠严重受损。创伤后应激障碍（PTSD）与睡眠困难增加有关，尤其是睡眠障碍、白天功能障碍和睡眠质量。在整个样本中的层次回归分析表明，PTSD 症状和担忧和对失去警觉的恐惧测量得分与睡眠困难呈正相关，而单位成员支持测量得分与睡眠困难呈负相关。在患有 PTSD 的退伍军人中，对失去警觉的恐惧与睡眠困难以及认知分心呈正相关，而单位成员支持与睡眠困难呈负相关。
寻求治疗的 OEF-OIF 退伍军人报告严重的睡眠困难，PTSD 退伍军人的睡眠障碍更为明显。这项研究的结果表明，减轻担忧和对失去警觉的恐惧以及增强感知的单位成员支持的干预措施可能有助于减少该人群从部署返回后的睡眠困难。
