VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA.
Curr Psychiatry Rep. 2013 Oct;15(10):401. doi: 10.1007/s11920-013-0401-4.
Insomnia is a prevalent disorder that greatly impacts military personnel, especially those deployed in support of combat efforts. Deployment-related stressors like combat exposure, mild traumatic brain injury (mTBI) irregular sleep-wake schedules, and adjustment to the return home all contribute to insomnia. However, insomnia can also exacerbate the deployment experience and is a risk factor for traumatic stress reactions such as PTSD, depression, and suicide. Military personnel with mTBI are significantly impacted by insomnia; the majority experience sleep disruption and this can impede recovery and rehabilitation. As more service members return home from deployment, treatment is vital to reduce the impact of insomnia. Preliminary outcome data, showing positive results for reduction of sleep disruption, has been found with treatments such as combined cognitive behavioral treatment of insomnia (CBTI) and imagery rehearsal therapy (IRT), preference-based interventions, as well as efforts to broadly disseminate CBTI. The recent literature on the impact and treatment of deployment-related insomnia is reviewed.
失眠是一种普遍的障碍,对军人,尤其是那些支持战斗行动的军人影响极大。与部署相关的压力源,如战斗暴露、轻度创伤性脑损伤(mTBI)、不规则的睡眠-觉醒时间表以及适应回国,都会导致失眠。然而,失眠也会加剧部署体验,是创伤后应激反应(如 PTSD、抑郁和自杀)的一个风险因素。患有 mTBI 的军人受失眠影响显著;大多数人经历睡眠中断,这会阻碍恢复和康复。随着越来越多的军人从部署中回国,治疗对于减轻失眠的影响至关重要。初步结果数据表明,认知行为治疗失眠(CBTI)和意象排练疗法(IRT)相结合的治疗、基于偏好的干预措施,以及广泛传播 CBTI 的努力,都可以减少睡眠中断。对与部署相关的失眠的影响和治疗的最新文献进行了回顾。