Sleep complaints as early predictors of posttraumatic stress disorder: a 1-year prospective study of injured survivors of motor vehicle accidents

Am J Psychiatry. 2002 May;159(5):855-7. doi: 10.1176/appi.ajp.159.5.855.

Abstract

Objective: Disturbed sleep is a common complaint among patients with posttraumatic stress disorder (PTSD) that appears in the reexperiencing and hyperarousal symptom clusters in DSM-IV. The causal relationship between sleep complaints and PTSD is unclear.

Method: Self-reported insomnia and excessive daytime sleepiness were assessed in 102 victims of motor vehicle accidents and 19 comparison subjects 1 week and 1, 3, 6, and 12 months after the trauma. At 12 months the Structured Clinical Interview for DSM-III-R was administered to determine diagnoses of PTSD.

Results: Twenty-six of the accident victims but none of the comparison subjects met the criteria for PTSD. Logistic regression models indicated that sleep complaints from 1 month on were significant in predicting PTSD at 1 year.

Conclusions: These results suggest that on the basis of sleep complaints as early as 1 month after the trauma, it is possible to detect subjects who will later develop chronic PTSD.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Traffic / psychology*
  • Adolescent
  • Adult
  • Aged
  • Comorbidity
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Middle Aged
  • Probability
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Risk Factors
  • Sleep Wake Disorders / diagnosis*
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / etiology
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / etiology
  • Survivors / psychology*
  • Wounds and Injuries / epidemiology
  • Wounds and Injuries / psychology*