Hohui E Wang1, Laura Campbell-Sills1, Ronald C Kessler2, Xiaoying Sun3, Steven G Heeringa4, Matthew K Nock5, Robert J Ursano6, Sonia Jain3, Murray B Stein1,3,7. 1. Department of Psychiatry, University of California San Diego, La Jolla, CA. 2. Department of Health Care Policy, Harvard Medical School, Boston, MA. 3. Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA. 4. Institute for Social Research, University of Michigan, Ann Arbor, MI. 5. Department of Psychology, Harvard University, Cambridge, MA. 6. Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD. 7. VA San Diego Healthcare System, San Diego, CA.
Abstract
Study Objectives: Insomnia is prevalent among military personnel and may increase risk of mental disorders and suicidal ideation. This study examined associations of pre-deployment insomnia with post-deployment post-traumatic stress disorder (PTSD) and suicidal ideation among US Army soldiers. Methods: Soldiers from three Brigade Combat Teams completed surveys 1-2 months before deploying to Afghanistan in 2012 (T0), on return from deployment (T1), 3 months later (T2), and 9 months later (T3). Logistic regression was performed to estimate associations of pre-deployment (T0) insomnia with post-deployment (T2 or T3) PTSD and suicidal ideation among respondents who completed surveys at all waves (n = 4645). A hierarchy of models incorporated, increasing controls for pre-deployment risk factors and deployment experiences. Results: Pre-deployment insomnia was associated with increased risk of post-deployment PTSD (adjusted odds ratio [AOR] = 3.14, 95% confidence interval [CI] = 2.58% to 3.82%, p < .0005) and suicidal ideation (AOR = 2.78, 95% CI = 2.07% to 3.74%, p < .0005) in models adjusting for sociodemographic characteristics and prior deployment history. Adjustment for other pre-deployment risk factors and deployment experiences attenuated these associations; however, insomnia remained significantly associated with post-deployment PTSD (AOR = 1.50, 95% CI = 1.19% to 1.89%, p = .001) and suicidal ideation (AOR = 1.43, 95% CI = 1.04% to 1.95%, p = .027). Subgroup models showed that pre-deployment insomnia was associated with incident PTSD (AOR = 1.55, 95% CI = 1.17% to 2.07%, p = .003) and suicidal ideation (AOR = 1.67, 95% CI = 1.16% to 2.40%, p = .006) among soldiers with no pre-deployment history of these problems. Conclusions: Pre-deployment insomnia contributed to prediction of post-deployment PTSD and suicidal ideation in Army soldiers, suggesting that detection of insomnia could facilitate targeting of risk mitigation programs. Future studies should investigate whether treatment of insomnia helps prevent PTSD and suicidal ideation among deployed service members.
Study Objectives:Insomnia is prevalent among military personnel and may increase risk of mental disorders and suicidal ideation. This study examined associations of pre-deployment insomnia with post-deployment post-traumatic stress disorder (PTSD) and suicidal ideation among US Army soldiers. Methods: Soldiers from three Brigade Combat Teams completed surveys 1-2 months before deploying to Afghanistan in 2012 (T0), on return from deployment (T1), 3 months later (T2), and 9 months later (T3). Logistic regression was performed to estimate associations of pre-deployment (T0) insomnia with post-deployment (T2 or T3) PTSD and suicidal ideation among respondents who completed surveys at all waves (n = 4645). A hierarchy of models incorporated, increasing controls for pre-deployment risk factors and deployment experiences. Results: Pre-deployment insomnia was associated with increased risk of post-deployment PTSD (adjusted odds ratio [AOR] = 3.14, 95% confidence interval [CI] = 2.58% to 3.82%, p < .0005) and suicidal ideation (AOR = 2.78, 95% CI = 2.07% to 3.74%, p < .0005) in models adjusting for sociodemographic characteristics and prior deployment history. Adjustment for other pre-deployment risk factors and deployment experiences attenuated these associations; however, insomnia remained significantly associated with post-deployment PTSD (AOR = 1.50, 95% CI = 1.19% to 1.89%, p = .001) and suicidal ideation (AOR = 1.43, 95% CI = 1.04% to 1.95%, p = .027). Subgroup models showed that pre-deployment insomnia was associated with incident PTSD (AOR = 1.55, 95% CI = 1.17% to 2.07%, p = .003) and suicidal ideation (AOR = 1.67, 95% CI = 1.16% to 2.40%, p = .006) among soldiers with no pre-deployment history of these problems. Conclusions: Pre-deployment insomnia contributed to prediction of post-deployment PTSD and suicidal ideation in Army soldiers, suggesting that detection of insomnia could facilitate targeting of risk mitigation programs. Future studies should investigate whether treatment of insomnia helps prevent PTSD and suicidal ideation among deployed service members.
Authors: Laura Campbell-Sills; Robert J Ursano; Ronald C Kessler; Xiaoying Sun; Steven G Heeringa; Matthew K Nock; Nancy A Sampson; Sonia Jain; Murray B Stein Journal: Psychol Med Date: 2017-10-17 Impact factor: 7.723
Authors: Alison Levin-Rector; Laurel L Hourani; Richard A Van Dorn; Robert M Bray; Valerie A Stander; Joel K Cartwright; Jessica K Morgan; James Trudeau; Pamela K Lattimore Journal: J Trauma Stress Date: 2018-07-19
Authors: Ronald C Kessler; Catherine Coulouvrat; Goeran Hajak; Matthew D Lakoma; Thomas Roth; Nancy Sampson; Victoria Shahly; Alicia Shillington; Judith J Stephenson; James K Walsh; Gary K Zammit Journal: Sleep Date: 2010-11 Impact factor: 5.849
Authors: Kevin M Swift; Connie L Thomas; Thomas J Balkin; Emily G Lowery-Gionta; Liana M Matson Journal: J Clin Sleep Med Date: 2022-09-01 Impact factor: 4.324
Authors: Katherine E Miller; Christine M Ramsey; Elaine M Boland; Elizabeth A Klingaman; Philip Gehrman Journal: Sleep Date: 2021-07-09 Impact factor: 5.849
Authors: Richard T Liu; Stephanie J Steele; Jessica L Hamilton; Quyen B P Do; Kayla Furbish; Taylor A Burke; Ashley P Martinez; Nimesha Gerlus Journal: Clin Psychol Rev Date: 2020-08-08
Authors: Dean T Acheson; Brian Kwan; Adam X Maihofer; Victoria B Risbrough; Caroline M Nievergelt; Jacob W Clark; Xin M Tu; Michael R Irwin; Dewleen G Baker Journal: Eur J Psychotraumatol Date: 2019-10-29
Authors: Quinn M Biggs; Robert J Ursano; Jing Wang; Gary H Wynn; Russell B Carr; Carol S Fullerton Journal: BMC Psychiatry Date: 2020-04-16 Impact factor: 3.630