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

Barry Krakow, Patricia L. Haynes, Teddy D. Warner, Erin Santana, Dominic Melendrez, Lisa Johnston, Michael Hollifield, Brandy N. Sisley, Mary Koss, Laura Shafer

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)257-268
Number of pages12
JournalJournal of Traumatic Stress
Volume17
Issue number3
DOIs
StatePublished - Jun 2004

Keywords

  • PTSD
  • insomnia
  • nightmares
  • obstructive sleep apnea
  • sleep
  • sleep-disordered breathing
  • upper airway resistance

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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