SLEEP DISTURBANCES IN THE VIETNAM GENERATION - FINDINGS FROM A NATIONALLY REPRESENTATIVE SAMPLE OF MALE VIETNAM VETERANS

Objective This study analyzed questionnaire items that address complai nts about sleep from the National Vietnam Veterans Readjustment Study, a nationally representative sample of the 3.1 million men and women w ho served in Vietnam. This study compared the frequency of nightmares and difficulties with sleep onset and sleep maintenance in male Vietna m theater veterans with male Vietnam era veteran and male civilian com parison subjects. It focused on the role of combat exposure, nonsleep posttraumatic st? ess disorder (PTSD) symptoms, comorbid psychiatric a nd medical disorder, and substance abuse in accounting for different d omains of sleep disturbance. Method: The authors undertook an archival analysis of the National Vietnam Veterans Readjustment Study database using correlations and linear statistical models. Results: Frequent n ightmares were found exclusively in subjects diagnosed with current PT SD at the time of the survey (15.0%). In the sample of veterans who se rved in Vietnam (N=1,167), combat exposure was strongly correlated wit h frequency of nightmares, moderately correlated with sleep onset inso mnia, and weakly cor? elated with disrupted sleep maintenance. A hiera rchical multiple regression analysis showed that in Vietnam theater ve terans, 57% of the variance in the frequency of nightmares was account ed for by war zone exposure and non-sleep-related PTSD symptoms. Alcoh ol abuse, chronic medical illnesses, panic disorder, major depression, and mania did not predict the frequency of nightmares after control f or nonsleep PTSD symptoms. Conclusions: Frequent nightmares appear to be virtu ally specific for PTSD. The nightmare is the domain of sleep disturbance most related to exposure to war zone traumatic stress.