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

Abstract

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 posttraumatic 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. © Association of Military Surgeons of the U.S. All rights reserved.