Many patients in Emergency Departments (ED) after motor vehicle collisions (MVC) develop posttraumatic stress disorder (PTSD) or major depressive episodes (MDE). This report from the AURORA study focuses on associations of pre-MVC sleep problems with these outcomes 8 weeks after MVC mediated through peritraumatic distress and dissociation and 2-week outcomes.
666 AURORA patients completed self-report assessments in the ED and at 2 and 8 weeks after MVC. Peritraumatic distress, peritraumatic dissociation and pre-MVC sleep characteristics (insomnia, nightmares, daytime sleepiness and sleep duration in the 30 days before the MVC, trait sleep stress reactivity) were assessed retrospectively in the ED. The survey assessed acute stress disorder (ASD) and MDE at 2 weeks and at 8 weeks assessed PTSD and MDE (past 30 days). Control variables included demographics, MVC characteristics, and retrospective reports about PTSD and MDE in the 30 days before the MVC.
Prevalence estimates were 41.0% for 2-week ASD, 42.0% for 8-week PTSD, 30.5% for 2-week MDE, and 27.2% for 8-week MDE. Pre-MVC nightmares and sleep stress reactivity predicted 8-week PTSD (mediated through 2-week ASD) and MDE (mediated through the transition between 2-week and 8-week MDE). Pre-MVC insomnia predicted 8-week PTSD (mediated through 2-week ASD). Estimates of population attributable risk suggest that blocking effects of sleep disturbance might reduce prevalence of 8-week PTSD and MDE by as much as one-third.
Targeting disturbed sleep in the immediate aftermath of MVC might be one effective way of reducing MVC-related PTSD and MDE.
© Sleep Research Society 2020. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.
About The Expert
Thomas C Neylan
Ronald C Kessler
Kerry J Ressler
Gari Clifford
Francesca L Beaudoin
Xinming An
Jennifer S Stevens
Donglin Zeng
Sarah D Linnstaedt
Laura T Germine
Sophia Sheikh
Alan B Storrow
Brittany E Punches
Kamran Mohiuddin
Nina T Gentile
Meghan E McGrath
Sanne J H van Rooij
John P Haran
David A Peak
Robert M Domeier
Claire Pearson
Leon D Sanchez
Niels K Rathlev
William F Peacock
Steven E Bruce
Jutta Joormann
Deanna M Barch
Diego A Pizzagalli
John F Sheridan
Steven E Harte
James M Elliott
Irving Hwang
Maria V Petukhova
Nancy A Sampson
Karestan C Koenen
Samuel A McLean
References
PubMed