Subjective sleep disturbance in veterans receiving care in the veterans affairs polytrauma system following blast-related mild traumatic brain injury.

Military medicine

PubMedID: 24005542

Farrell-Carnahan L, Franke L, Graham C, McNamee S. Subjective sleep disturbance in veterans receiving care in the veterans affairs polytrauma system following blast-related mild traumatic brain injury. Mil Med. 2013;178(9):951-6.
OBJECTIVES
This investigation sought to characterize prevalence and factors associated with subjective sleep disturbance (SSD) in a clinical sample of veterans with blast-related mild traumatic brain injury (mTBI).

METHODS
Adult veterans with history of blast-related mTBI were enrolled in a cross-sectional study. Data on demographics, injury, and current symptoms, including SSD, were obtained. Descriptive and univariate analyses investigated prevalence of SSD and associated factors.

RESULTS
Participants were 114 veterans with blast-related mTBI (96% male; mean age = 31 years, SD = 8; mean number of days since injury =1,044, SD = 538). 78% screened positive for post-traumatic stress disorder and 77% reported SSD. Loss of consciousness at time of injury, current nightmares, depression, headache, fatigue, and positive screen for post-traumatic stress disorder were significantly associated with SSD (p < 0.05).

CONCLUSIONS
SSD was pervasive in this clinical sample and was significantly associated with multiple modifiable emotional symptoms as well as headache and fatigue; this is consistent with previous literature including samples with history of nonblast-related mTBI. Future research incorporating objective measurement of SSD and associated symptoms is needed to inform evidence-based screening, assessment, and treatment efforts for veterans with history of mTBI.