Publication year
2010
Citation Title
Insomnia is the most commonly reported symptom and predicts other symptoms of post-traumatic stress disorder in U.S. service members returning from military deployments.
Journal Name
Military Medicine
Journal Volume
175
Issue Number
10
Page Numbers
759-762
DOI
10.7205/milmed-d-10-00193
Summary
Service members who had recently returned from deployment were screened at the Naval Medical Center in San Diego over a two year period. This study focused on rates of posttraumatic stress disorder (PTSD) symptoms upon initial return and 3 months later. Insomnia was the most common PTSD symptom reported and had the highest average severity score of any PTSD symptom.
Key Findings
Insomnia was the most common symptom of PTSD reported by Service members returning from military deployments. Specifically, 33% of Service members reported some degree of insomnia upon returning, and 37% reported some insomnia three months after homecoming.
Insomnia was often reported as mild, and individuals with complaints of insomnia had higher scores of PTSD at follow-up.
Regarding symptom severity, insomnia was the highest of any PTSD symptom reported.
Insomnia complaints and overall PTSD scores were higher in Service members deployed to Iraq or Afghanistan (41%) than those deployed elsewhere (25%).
Implications for Program Leaders
Offer classes to Service members about sleep hygiene, both during and after deployment
Create opportunities for support groups for partners of Service members with PTSD wherein they could exchange social support, information, and resources
Disseminate information regarding possible symptoms of mental health problems Service members may face after deployment and where individuals and families can find help for those problems
Implications for Policy Makers
Recommend screening returning Service members for sleep problems and the provision of appropriate referrals in current programs
Promote reintegration programs that include attention to assisting Service members’ family in adjusting to the Service member’s return
Recommend professional education including information on insomnia and mental health for professionals who work with Service members and their families
Methods
Service members were screened upon returning home from deployment with the Postdeployment Health Assessment Test at the Naval Medical Center in San Diego between January 2005 and October 2007.
The screening contained demographic items and questions about risk exposures and PTSD symptoms.
Some participants completed an initial screening (77%), some completed only a follow-up assessment (23%), and others completed both (18%).
Statistical analyses was used to compare the 17 PTSD symptoms in terms of their severity and frequency, as well as differences between PTSD scores between initial and follow-up screenings.
Participants
A total of 1,887 individuals were included (76% male) in this study.
Of the participants, the average age was 29.10 years, ranging between 18-57 years with an average of 7.2 years of service. The average number of previous deployments was 2.6 and average number of months deployed was 5.40 months.
Eighty-four percent of the sample were in the Navy, 15% were in the Marines, and 2% were other service branches. No racial/ethnic data were presented.
Limitations
The population consisted primarily of Sailors, a high percentage of female Service members, and a larger proportion of medical personnel and injured Service members than is representative of the military as a whole; therefore, the extent to which these results apply to other groups is unknown.
All measures were self-reported instead of a clinical interview or observation, increasing the risk of social desirability biases.
No measure of sleep concerns was used which limits the ability to confidently conclude accuracy of participants' responses were reflective of insomnia.
Avenues for Future Research
Replicate the study using validated measures of sleep problems with returning Service members
Gather longitudinal data on sleep concerns to explore if Service members' sleep problems persist or resolve over time
Obtain spousal or parental report of Service members' sleep concerns to collect more comprehensive data on their sleep habits
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
This study retrospectively reviewed records from current members of the U.S. military who had completed the PTSD Checklist (PCL) at 0 and 3-months after returning from deployments. Insomnia was the most commonly reported symptom of PTSD on the PCL and had the highest average severity scores. At initial screen, 41% of those who had been to Iraq or Afghanistan reported sleep problems. Those who had initially reported any insomnia had significantly higher overall scores for PTSD severity at follow-up than did service members without such a complaint. These results show that insomnia is a particularly frequent, severe, and persistent complaint in service members returning from deployment. Such complaints merit particular attention in relation to the possibility of PTSD.
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