Martindale Sarah L, Konst Matthew J, Bateman James R, Arena Alyssa, Rowland Jared A
Salisbury VA Medical Center, Salisbury, North Carolina.
Mid-Atlantic MIRECC, Durham, North Carolina.
Mil Psychol. 2020 Feb 14;32(2):212-221. doi: 10.1080/08995605.2020.1724595. eCollection 2020.
The purpose of this study was to evaluate the main and interaction effects of PTSD and TBI on sleep outcomes in veterans. Post-deployment combat veterans ( = 293, 87.37% male) completed clinical interviews to determine diagnosis and severity of PTSD and deployment TBI history, as well as subjective measures of sleep quality, sleep duration, and restedness. Sleep-related medical diagnoses were extracted from electronic medical records for all participants. PTSD and TBI were each associated with poorer ratings of sleep quality, restedness, shorter sleep duration, and greater incidence of clinically diagnosed sleep disorders. Analyses indicated main effects of PTSD on sleep quality ( < .001), but no main effects of TBI. PTSD severity was significantly associated with poorer sleep quality ( < .001), restedness ( = .018), and shorter sleep duration ( = .015). TBI severity was significantly associated with restedness beyond PTSD severity ( = .036). There were no interaction effects between diagnostic or severity variables. PTSD severity is a driving factor for subjective ratings of sleep disturbance beyond PTSD diagnosis as well as TBI diagnosis and severity. Despite this, poor sleep was apparent throughout the sample, which suggests post-deployment service members may globally benefit from routine screening of sleep problems and increased emphasis on sleep hygiene.
本研究的目的是评估创伤后应激障碍（PTSD）和创伤性脑损伤（TBI）对退伍军人睡眠结果的主要影响和交互作用。部署后参战退伍军人（n = 293，87.37%为男性）完成了临床访谈，以确定PTSD的诊断和严重程度以及部署期间的TBI病史，以及睡眠质量、睡眠时间和休息程度的主观测量。从所有参与者的电子病历中提取与睡眠相关的医学诊断。PTSD和TBI均与睡眠质量较差、休息程度较差、睡眠时间较短以及临床诊断的睡眠障碍发生率较高相关。分析表明，PTSD对睡眠质量有主要影响（p <.001），但TBI没有主要影响。PTSD严重程度与较差的睡眠质量（p <.001）、休息程度（p =.018）和较短的睡眠时间（p =.015）显著相关。TBI严重程度在PTSD严重程度之外与休息程度显著相关（p =.036）。诊断或严重程度变量之间没有交互作用。PTSD严重程度是PTSD诊断以及TBI诊断和严重程度之外睡眠障碍主观评分的驱动因素。尽管如此，整个样本中睡眠质量差的情况很明显，这表明部署后的军人可能总体上会从常规的睡眠问题筛查和对睡眠卫生的更多重视中受益。
