Boiko D. I.

SLEEP PROBLEMS IN COMBATANTS WITH POSTTRAUMATIC STRESS DISORDER AND ITS ACCEPTANCE

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About the author:

Boiko D. I.

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CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

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For decades, sleep problems have become increasingly common among military personnel. Along with this, participation in active hostilities contributes to the development of stress-associated mental disorders, which sleep disturbances may accompany. However, sleep medicine has not thoroughly studied the role of acceptance of sleep problems. Along with this, the level of acceptance of sleep problems among combatants, as well as its differences in the presence of PTSD, has not been studied to date. We conducted a clinical study of 45 combatants, who were divided into two groups: group 1 (n=24) – combatants with PTSD; group 2 (n=21) – combatants without PTSD. Patients ‘ complaints about sleep disturbances were collected, sleep quality was analyzed using the Pittsburgh Sleep Quality Questionnaire, and acceptance level was determined according to the Sleep Problems Acceptance Questionnaire. The predominance of complaints about nightmares and difficulty falling asleep among patients of group 1 was established (p<0.001 and p=0.027, respectively). We found that among the participants of group 1, poor sleep quality occurred statistically significantly more often (p<0.001). Group 1 patients had a lower level of activity involvement (p=0.023) and a reduced level of acceptance of sleep problems compared to group 2 (p=0.017). Thus, we demonstrated that combatants have significant sleep problems and a high frequency of poor sleep quality. Among the complaints of sleep problems independent of PTSD in combatants, insufficiently restorative sleep and frequent awakenings are most often noted. With PTSD, combatants have a higher frequency of complaints of difficulty falling asleep and nightmares, as well as a lower level of acceptance of sleep problems, in particular, involvement in activities, which should be taken into account when developing a treatment strategy and choosing a psychotherapeutic approach.

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1. Shkodina AD, Tan SC, Hasan MM, Abdelgawad M, Chopra H, Bilal M, et al. Roles of clock genes in the pathogenesis of Parkinson’s disease. Ageing Res Rev. 2022;74:101554. DOI: https://doi.org/10.1016/j.arr.2021.101554.
2. Feemster JC, Smith KL, McCarter SJ, St. Louis EK. Trauma-Associated Sleep Disorder: A Posttraumatic Stress/REM Sleep Behavior Disorder Mash-Up? J Clin Sleep Med. 2019;15:345–9. DOI: https://doi.org/10.5664/jcsm.7642.
3. Carlson GC, Sharifian N, Jacobson IG, LeardMann CA, Rull RP, Martin JL, et al. Contribution of post-trauma insomnia to depression and posttraumatic stress disorder in women service members: findings from the Millennium Cohort Study. Sleep. 2023;46(3):zsac313. DOI: https://doi.org/10.1093/sleep/zsac313.
4. Troxel WM, Shih RA, Pedersen ER, Geyer L, Fisher MP, Griffin BA, et al. Sleep in the Military: Promoting Healthy Sleep Among U.S. Servicemembers. Rand Heal Q. 2015;5:19.
5. Caldwell JA, Knapik JJ, Shing TL, Kardouni JR, Lieberman HR. The association of insomnia and sleep apnea with deployment and combat exposure in the entire population of US army soldiers from 1997 to 2011: a retrospective cohort investigation. Sleep. 2019;42(8):zsz112. DOI: https://doi.org/10.1093/sleep/zsz112.
6. Boiko DI, Shyrai PO, Mats OV, Karpik ZI, Rahman MH, Khan AA, et al. Mental health and sleep disturbances among Ukrainian refugees in the context of Russian-Ukrainian war: A preliminary result from online-survey. Sleep Med. 2024;113:342–8. DOI: https://doi.org/10.1016/j.sleep.2023.12.004.
7. Bramoweth AD, Germain A. Deployment-Related Insomnia in Military Personnel and Veterans. Curr Psychiatry Rep. 2013;15:401. DOI: https://doi.org/10.1007/s11920-013-0401-4.
8. Boiko DI, Skrypnikov AM, Shkodina AD, Hasan MM, Ashraf GM, Rahman MH. Circadian rhythm disorder and anxiety as mental health complications in post-COVID-19. Environ Sci Pollut Res. 2022;29:28062–9. DOI: https://doi.org/10.1007/s11356-021-18384-4.
9. Aborode AT, Pustake M, Awuah WA, Alwerdani M, Shah P, Yarlagadda R, et al. Targeting Oxidative Stress Mechanisms to Treat Alzheimer’s and Parkinson’s Disease: A Critical Review. Oxid Med Cell Longev. 2022;2022:1–9. DOI: https://doi.org/10.1155/2022/7934442.
10. Dmytriv TR, Tsiumpala SA, Semchyshyn HM, Storey KB, Lushchak VI. Mitochondrial dysfunction as a possible trigger of neuroinflammation at post-traumatic stress disorder (PTSD). Front Physiol. 2023;14:1222826. DOI: https://doi.org/10.3389/fphys.2023.1222826.
11. Gutner CA, Pedersen ER, Drummond SPA. Going direct to the consumer: Examining treatment preferences for veterans with insomnia, PTSD, and depression. Psychiatry Res. 2018;263:108–14. DOI: https://doi.org/10.1016/j.psychres.2018.02.045.
12. Martindale SL, Lad SS, Ord AS, Nagy KA, Crawford CD, Taber KH, et al. Sleep moderates symptom experience in combat veterans. J Affect Disord. 2021;282:236–41. DOI: https://doi.org/10.1016/j.jad.2020.12.161.
13. Patel TA, Blakey SM, Halverson TF, Mann AJD, Calhoun PS, Beckham JC, et al. Experiential Avoidance, Posttraumatic Stress Disorder, and Self-Injurious Thoughts and Behaviors: A Moderation Analysis in a National Veteran Sample. Int J Cogn Ther. 2023;16:340–55. DOI: https://doi.org/10.1007/s41811-023-00164-2.
14. Saldaña KS, McGowan SK, Martin JL. Acceptance and Commitment Therapy as an Adjunct or Alternative Treatment to Cognitive Behavioral Therapy for Insomnia. Sleep Med Clin. 2023;18:73–83. DOI: https://doi.org/10.1016/j.jsmc.2022.09.003.
15. Bothelius K, Jernelöv S, Fredrikson M, McCracken LM, Kaldo V. Measuring Acceptance of Sleep Difficulties: The Development of the Sleep Problem Acceptance Questionnaire. Sleep. 2015;38:1815–22. DOI: https://doi.org/10.5665/sleep.5170.
16. Lancel M, van Marle HJF, Van Veen MM, van Schagen AM. Disturbed Sleep in PTSD: Thinking Beyond Nightmares. Front Psychiatry. 2021;12:767760. DOI: https://doi.org/10.3389/fpsyt.2021.767760.
17. Saguin E, Gomez-Merino D, Sauvet F, Leger D, Chennaoui M. Sleep and PTSD in the Military Forces: A Reciprocal Relationship and a Psychiatric Approach. Brain Sci. 2021;11:1310. DOI: https://doi.org/10.3390/brainsci11101310.
18. Rosen RC, Cikesh B, Fang S, Trachtenberg FL, Seal KH, Magnavita AM, et al. Posttraumatic Stress Disorder Severity and InsomniaRelated Sleep Disturbances: Longitudinal Associations in a Large, Gender-Balanced Cohort of Combat-Exposed Veterans. J Trauma Stress. 2019;32:936–45. DOI: https://doi.org/10.1002/jts.22462.
19. Plumb TR, Peachey JT, Zelman DC. Sleep disturbance is common among servicemembers and veterans of Operations Enduring Freedom and Iraqi Freedom. Psychol Serv. 2014;11:209–19. DOI: https://doi.org/10.1037/a0034958.
20. Blom K, Hentati Isacsson N, Forsell E, Rosén A, Kraepelien M, Jernelöv S, et al. An investigation and replication of sleep-related cognitions, acceptance and behaviours as predictors of short- and long-term outcome in cognitive behavioural therapy for insomnia. J Sleep Res. 2021;30:e13376. DOI: https://doi.org/10.1111/jsr.13376.
21. Salari N, Khazaie H, Hosseinian-Far A, Khaledi-Paveh B, Ghasemi H, Mohammadi M, et al. The effect of acceptance and commitment therapy on insomnia and sleep quality: A systematic review. BMC Neurol. 2020;20:300. DOI: https://doi.org/10.1186/s12883-020-01883-1.
22. Prevedini AB, Presti G, Rabitti E, Miselli G, Moderato P. Acceptance and commitment therapy (ACT): the foundation of the therapeutic model and an overview of its contribution to the treatment of patients with chronic physical diseases. G Ital Med Lav Ergon. 2011;33:A53- 63.

Publication of the article:

«Bulletin of problems biology and medicine», 2024 Issue 2, 173, 165-174 pages, index UDC 617.8-009.836-092:616.89:355.292

DOI:

10.29254/2077-4214-2024-2-173-165-174