A new study conducted by the Perelman School of Medicine at the University of Pennsylvania and the Naval Health Research Centre published in the July, 2013 issue of the journal SLEEP showed that military personnel who suffered from insomnia prior to deployment had a much greater chance of returning home with post traumatic stress disorder (PTSD), anxiety or depression.
It showed that pre-existing sleep problems conferred almost as large a risk for those mental disorders as combat exposure itself.
Lead study author Philip Gehrman, PhD, assistant professor of Psychology in the Department of Psychiatry, member of the Penn Sleep Centre, and the Philadelphia VA Medical Centre said, “Understanding environmental and behavioural risk factors associated with the onset of common major mental disorders is of great importance in a military occupational setting.”
Mr. Gehrman added, “This study is the first prospective investigation of the relationship between sleep disturbance and development of newly identified positive screens for mental disorders in a large military cohort who have been deployed in support of the recent operations in Iraq or Afghanistan.”
The data was collected from 15,204 service members, including only those servicemen and women on the timing of their first deployment across all branches and components of military service. A self-reported data from the millennium cohort study was also used. The Millennium Cohort Study is funded through the Military Operational Medicine Research Program of the US Army Medical Research and Materiel Command, Fort Detrick, Maryland.
The team evaluated the link between sleep duration and insomnia symptoms that were present before deployment and the onset of new mental health problems amongst those deployed. Multivariable logistic regression was utilized to get an idea about the odds of suffering from mental health problems like PTSD, depression and anxiety. The data was adjusted for covariates like combat trauma.
The results showed a good degree of association between the two. 522 people with new-onset PTSD were identified, 151 with anxiety and 303 with depression after deployment.
Mr Gehrman said, “One of the more interesting findings of this study is not only the degree of risk conferred by pre-deployment insomnia symptoms, but also the relative magnitude of this risk compared with combat-related trauma.”
“The risk conferred by insomnia symptoms was almost as strong as our measure of combat exposure in adjusted models,” he further added.
When the adjusted models were compared, combat-related trauma and pre-deployment insomnia symptoms were significantly associated with higher odds of developing posttraumatic stress disorder, depression, and anxiety.
Another interesting finding was revealed that short duration sleep (less than six hours per night), when not considered with general insomnia was also related to new onset of PTSD symptoms.
“We found that insomnia is both a symptom and a risk factor for mental illness and may present a modifiable target for intervention among military personnel,” says Gehrman. “We hope that by early identification of those most vulnerable, the potential exists for the designing and testing of preventive strategies that may reduce the occurrence of PTSD, anxiety, and depression.”
Researchers concluded that additional study is required to check whether early and effective intervention can reduce subsequent morbidity from mental disorders. This early check can include a routine inquiry about insomnia symptoms. This can be included into the pre-deployment routine screening as well.
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