Go Back Research Article June, 2005

Nightmares, insomnia, and sleep-disordered breathing in fire evacuees seeking treatment for posttraumatic sleep disturbance

Author Mary P. Koss Author Barry Krakow Author Michael A. Hollifield Author LISA GRAZINA JOHNSTON Author TEDDY D WARNER Author Dominic Melendrez Author Patricia Haynes

Abstract

Eight months after the Cerro Grande Fire, 78 evacuees seeking treatment for posttraumatic sleep disturbances were assessed for chronic nightmares, psychophysiological insomnia, and sleep-disordered breathing symptoms. Within this sample, 50% of participants were tested objectively for sleep-disordered breathing; 95% of those tested screened positive for sleep-disordered breathing. Multiple regression analyses demonstrated that these three sleep disorders accounted for 37% of the variance in posttraumatic stress symptoms, and each sleep disorder was significantly and independently associated with posttraumatic stress symptoms severity. The only systematic variable associated with posttraumatic stress symptoms of avoidance was sleep-disordered breathing. The findings suggest that three common sleep disorders relate to posttraumatic stress symptoms in a more complex manner than explained by the prevailing psychiatric paradigm, which conceptualizes sleep disturbances in PTSD merely as secondary symptoms of psychiatric distress.

Keywords

PTSD Sleep Nightmares Insomnia Sleep-Disordered Breathing (SDB) Obstructive Sleep Apnea (OSA) Upper Airway Resistance Posttraumatic Sleep Disturbance Fire Evacuees PTSD Symptoms Psychophysiological Insomnia Chronic Nightmares Sleep Disorder Assessment Sleep And Trauma Posttraumatic Stress Severity Sleep Disorder Screening Avoidance Symptoms Psychiatric Paradigm Cerro Grande Fire Respiratory Sleep Disorders
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Volume 17
Issue 3
Pages 257-268
DOI 10.1023/B:JOTS.0000029269.29098.67
ISSN 0894-9867
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