Complex insomnia: Insomnia and sleep-disordered breathing in a consecutiveseries of crime victims with nightmares and PTSD

Background: Sleep disturbance in posttraumatic stress disorder is very comm on. However, no previous postraumatic stress disorder studies systematicall y examined sleep breathing disturbances, which might influence night mares, insomnia, and posttraumatic stress disorder symptoms, Methods: Forty-four consecutive crime victims with nightmares and insomnia underwent standard polysomnography coupled with a nasal pressure transducer to measure airflow limitation diagnostic of obstructive sleep apnea and up per airway resistance syndrome. Results: Forty of 44 participants tested positive on objective sleep studie s based on conservative respiratory disturbance indices of more than 15 eve nts per hour; 22 patients suffered from obstructive sleep apnea and 18 suff ered from upper airway resistance syndrome, Conclusions: In an uncontrolled study, insomnia and sleep-disordered breath ing were extremely prevalent in this small and select sample of crime victi ms. Research is needed to study I) prevalence of sleep-disordered breathing in other posttraumatic stress disorder populations using appropriate contr ols and nasal pressure transducers and 2) effects of sleep treatment on pos ttraumatic stress symptoms in trauma survivors with comorbid obstructive sl eep apnea or upper airway resistance syndrome, In the interim, some post tr aumatic stress disorder patients may benefit from sleep medicine evaluation s. (C) 2001 Society of Biological Psychiatry.