Impact of sleep disturbance on recovery in veterans with PTSD and TBI

Poor sleep may impact treatment and recovery in veterans with Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). A review of extensive research on sleep in TBI and PTSD has found that sleep-focused interventions can improve treatment outcomes in veterans.

Led by researchers at Boston University School of Medicine (BUSM) and VA Boston Healthcare System, the review article currently appears online in the journal of Clinical Psychology Review.

Sleep difficulty is a primary symptom of both PTSD and TBI and has been found to affect the severity of both conditions. TBI patients can suffer from permanent sleep problems regardless of the severity of their initial injury. Approximately 40 to 65 percent of individuals have insomnia after mild TBI, while patients with sleep difficulties are at a higher risk of developing PTSD. Despite recent attention, sleep has been understudied in the veteran population.

The review found that poor sleep often persists in veterans after resolution of their PTSD and mild TBI symptoms, but few treatments and rehabilitation protocols target sleep specifically. "In these veterans, sleep disturbances continue to adversely impact daily functioning and quality of life. "PTSD, TBI, and sleep problems significantly affect functional status and quality of life in veterans returning from combat," explains lead author Yelena Bogdanova, PhD, assistant professor of psychiatry at BUSM add VA title.

According to the researchers sleep is critical for restorative processes and evaluation of sleep problems should be integral to the clinical management of PTSD and TBI. "Understanding sleep problems and their role in the development and maintenance of PTSD and TBI symptoms may lead to improvement in overall treatment outcomes," added Bogdanova. "Future research efforts," she proposes, "should target the development of sleep-focused interventions."