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Exploring the role of insomnia in the relation between PTSD and pain in veterans with polytrauma injuries

LANG KP; VEAZEY MORRIS K; ANDRASIK F
J HEAD TRAUMA REHABIL , 2014, vol. 29, n° 1, p. 44-53
Doc n°: 166750
Localisation : Centre de Réadaptation de Lay St Christophe

D.O.I. : http://dx.doi.org/DOI:10.1097/HTR.0b013e31829c85d0
Descripteurs : DA42 - POLYTRAUMATISMES, AD72 - TROUBLES DU SOMMEIL, LA - PSYCHOLOGIE

Soldiers returning from Operation Enduring Freedom/Operation Iraqi
Freedom experience polytrauma injuries including traumatic brain injury.
Traumatic brain injury is often complicated by symptoms of insomnia,
posttraumatic stress disorder (PTSD), and pain that can impact treatment and
rehabilitation. METHODS: The medical records of 137 veterans seen at a Veterans
Affairs Medical Center Polytrauma clinic who sustained traumatic brain injury in
combat were reviewed for this study. Demographic variables include age, sex,
ethnicity, military branch, and service connection. Outcome measures include
PTSD, pain, and insomnia. RESULTS: Analyses revealed a high prevalence of PTSD,
insomnia, and pain co-occurring in 51.8% of veterans. Increased PTSD
symptomatology was significantly correlated with reports of more pain severity (r
= 0.53), pain interference (r = 0.61), and insomnia (r = 0.67). Further analyses,
controlling for service connection, indicated that insomnia partially mediated
the relation between PTSD and both pain severity and interference. CONCLUSIONS:
These results highlight the overlap and complexity of presenting complaints in
veterans and help identify the role of sleep disturbances in complicating
diagnosis and treatment of veterans. As sleep problems reduce pain tolerance and
exacerbate other symptoms, such as cognitive deficits and irritability, failure
to address sleep disturbances may compromise rehabilitation efforts, suggesting
the importance of a multidisciplinary team approach to assessing and treating
these veterans.

Langue : ANGLAIS

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