Sleep quality problems three decades post-disaster

The association of polysomnographic sleep on posttraumatic stress disorder symptom clusters in trauma-exposed civilians and veterans

Study Objectives

Self-reported sleep disturbance has been established as a risk factor and predictor for posttraumatic stress disorder (PTSD); however, less is known about the relationship between objective sleep and PTSD symptom clusters, and the specific role of hyperarousal. The present study examined the relationships between sleep continuity and architecture on PTSD symptom clusters.

Methods

Participants underwent two in-laboratory sleep studies to assess sleep continuity and architecture. They also completed the Clinician-Administered PTSD-IV scale and the Structured Clinical Interview for the DSM-IV to assess for PTSD diagnosis and other psychiatric disorders.

Results

Sleep continuity (i.e. total sleep time, sleep efficiency percent, wake after sleep onset, sleep latency) was significantly related to PTSD Cluster B (reexperiencing) symptom severity (R ² = .27, p < .001). Sleep architecture, specifically Stage N1 sleep, was significantly associated with PTSD Cluster B (t = 2.98, p = .004), C (Avoidance; t = 3.11, p = .003), and D (Hyperarosual; t = 3.79, p < .001) symptom severity independently of Stages N2, N3, and REM sleep. REM sleep variables (i.e. REM latency, number of REM periods) significantly predicted Cluster D symptoms (R ² = .17, p = .002).

Conclusions

These data provide evidence for a relationship between objective sleep and PTSD clusters, showing that processes active during Stage N1 sleep may contribute to PTSD symptomatology in civilians and veterans. Further, these data suggest that arousal mechanisms active during REM sleep may also contribute to PTSD hyperarousal symptoms.This paper is part of the War, Trauma, and Sleep Across the Lifespan Collection. This collection is sponsored by the Sleep Research Society.

From a first person perspective: Soldiers' experiences three decades after an avalanche - A qualitative interview study

STUDY OBJECTIVES

The aim of this study was to explore indirectly exposed soldiers' subjective experiences following an avalanche. Three decades after the trauma, this study describes the perceived impact of the disaster by peers of those who survived or died in the avalanche.

METHOD

A qualitative, cross-sectional, study based on 17 individual interviews with persons indirectly exposed to an avalanche. Data was analysed according to qualitative content analysis.

FINDINGS

The findings revealed 'being a significant first person' as the main theme. Two categories were developed: 1) Experience of closeness to the victims 2) Experience of distance post-disaster. The categories elaborated two subcategories each: 1) Could have been me 2) Sadness, grief, shame and guilt over losing friends and 1) Unorganized military service post-disaster 2) Anger towards the system.

CONCLUSION

The soldiers indirectly exposed to the avalanche need to be seen both as a person and as a group. Both immediately following and decades after the disaster, the informants wanted the military to offer adequate follow-up.

Sleep Problems among Disaster Victims: A Long-Term Survey on the Life Changes of Disaster Victims in Korea

This study aimed to assess sleep problems and their underlying factors in victims of disasters such as typhoons, heavy rains, fires, and earthquakes. Data from the long-term survey on life changes among disaster victims in 2019 obtained by the National Disaster Management Research Institute were used. The study included 1358 victims of natural and social disasters in Korea between 2012 and 2018. Sleep problems were assessed using a survey on subjective sleep quality and the use of sleeping medication. The data were analyzed using the chi-square test, t-test, and binominal logistic regression. The results showed that the factors affecting subjective sleep quality included disaster type, time elapsed after disaster, subjective health status, depression, and posttraumatic stress disorder. The factors affecting sleep medication use included age, time elapsed after disaster, and posttraumatic stress disorder. Therefore, interventions and support systems should be provided to prevent the prolongation of sleep problems.

The experiences of dealing with consequences of an avalanche - surviving soldiers' perspectives

Purpose: The aim of the study was to explore and describe experiences of daily life after having experienced an avalanche three decades ago.Method: This paper presents a qualitative study of 12 male survivors of an avalanche during their military service, interviewed 30 years post-disaster.Findings: A comprehensive understanding of the categories led to the latent theme "Finding my own way of managing and dealing with life". Findings revealed three categories describing experiences of daily living: (i) A comfortable life; (ii) A challenging, yet accomplished life; (iii) A demanding life. The first category represents a greater degree of using adaptive coping strategies for managing everyday life compared to the other two categories. The third category represents the group having the most challenging consequences. Among the three, the latter category conveys the most maladaptive coping strategies.Conclusions:The participants had different experiences with regards to their health and how they coped with their everyday life after the avalanche disaster. Insights into coping strategies may provide a guide for appropriate interventions for survivors dealing with traumatic events.