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J Trauma Stress. 2017 Jun;30(3):219-228. doi: 10.1002/jts.22196. Epub 2017 Jun 6.

Life Threat and Sleep Disturbances in Adolescents: A Two-Year Follow-Up of Survivors From the 2011 Utøya, Norway, Terror Attack.

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Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
The Cognitive Developmental Unit (EKUP), Department of Psychology, University of Oslo, Oslo, Norway.
Department of Radiology, Haukeland University Hospital, Bergen, Norway.
Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom.
Department of Psychosocial Science, University of Bergen, Bergen, Norway.
Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, Bergen, Norway.
Research Group for Cognitive and Clinical Neuroscience, Department of Psychology, University of Oslo, Oslo, Norway.
Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.


A significant number of adolescents have been exposed to traumatic life events. However, knowledge about the specific sleep disturbance that occurs in individuals after trauma exposure is predominantly based on studies of adults. This study reports specific sleep disturbance in 42 survivors of the 2011 mass shooting at a youth summer camp on the Norwegian island Utøya, mean age = 20.91 years, SD = 2.32, 62.5% females. When compared with matched controls, significantly more survivors reported having sleep disturbances, 52.4% versus 13.6%, d = 0.93, of which onset began at the time of the shooting, χ2 = 14.9, p < .001. The prevalence of insomnia, 56.3% versus 11.0%, d = 0.73; excessive daytime sleepiness, 34.4% versus 13.6%, d = 0.61; symptoms of obstructive sleep apnea, 18.8% versus 0%, d = 0.70; and frequent nightmares, 37.5% versus 2.3%, d = 0.90, were all higher in the survivors than in the controls. In a subgroup of survivors (n = 20) with psychiatric diagnoses, sleep disturbances were more prevalent than in survivors without psychiatric diagnosis. Actigraphy data revealed delayed bedtime, sleep onset, and rise time in survivors compared with controls, ts > 1.7, ps = .044 to .028. These results corroborate the effects of a life threat on the range and extent of sleep disturbances, and emphasize the need to better assess and treat sleep disorders in adolescents exposed to trauma.

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