Sleep breathing and sleep movement disorders masquerading as insomnia in sexual-assault survivors

Krakow, Barry; Germain, Anne; Tandberg, Dan; Koss, Mary; Schrader, Ron; Hollifield, Michael; Cheng, Diana; Edmond, Tonya

« Previous Next »Comprehensive Psychiatry
Volume 41, Issue 1 , Pages 49-56, January 2000

Sleep breathing and sleep movement disorders masquerading as insomnia in sexual-assault survivors☆

Barry Krakow
- Address reprint requests to Barry Krakow, M.D., UNM Sleep Research, 4775 Indian School Rd NE, Suite 305, Albuquerque, NM 87110.
- Department of Emergency Medicine and the Department of Psychiatry, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- Department of Psychology, University of Montreal, Montreal, Canada
- Laboratoire des rêves et des cauchemars, Hôpital Sacré-Coeur, Montreal, Quebec, Canada
- University of Arizona Health Sciences Center, Tucson, Az, USA
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, USA
- Department of Family and Community Medicine, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA
- George Warren Brown School of Social Work, Washington University, St Louis, MO, USA
Anne Germain
- Department of Emergency Medicine and the Department of Psychiatry, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- Department of Psychology, University of Montreal, Montreal, Canada
- Laboratoire des rêves et des cauchemars, Hôpital Sacré-Coeur, Montreal, Quebec, Canada
- University of Arizona Health Sciences Center, Tucson, Az, USA
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, USA
- Department of Family and Community Medicine, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA
- George Warren Brown School of Social Work, Washington University, St Louis, MO, USA
Dan Tandberg
- Department of Emergency Medicine and the Department of Psychiatry, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- Department of Psychology, University of Montreal, Montreal, Canada
- Laboratoire des rêves et des cauchemars, Hôpital Sacré-Coeur, Montreal, Quebec, Canada
- University of Arizona Health Sciences Center, Tucson, Az, USA
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, USA
- Department of Family and Community Medicine, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA
- George Warren Brown School of Social Work, Washington University, St Louis, MO, USA
Mary Koss
- Department of Emergency Medicine and the Department of Psychiatry, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- Department of Psychology, University of Montreal, Montreal, Canada
- Laboratoire des rêves et des cauchemars, Hôpital Sacré-Coeur, Montreal, Quebec, Canada
- University of Arizona Health Sciences Center, Tucson, Az, USA
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, USA
- Department of Family and Community Medicine, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA
- George Warren Brown School of Social Work, Washington University, St Louis, MO, USA
Ron Schrader
- Department of Emergency Medicine and the Department of Psychiatry, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- Department of Psychology, University of Montreal, Montreal, Canada
- Laboratoire des rêves et des cauchemars, Hôpital Sacré-Coeur, Montreal, Quebec, Canada
- University of Arizona Health Sciences Center, Tucson, Az, USA
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, USA
- Department of Family and Community Medicine, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA
- George Warren Brown School of Social Work, Washington University, St Louis, MO, USA
Michael Hollifield
- Department of Emergency Medicine and the Department of Psychiatry, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- Department of Psychology, University of Montreal, Montreal, Canada
- Laboratoire des rêves et des cauchemars, Hôpital Sacré-Coeur, Montreal, Quebec, Canada
- University of Arizona Health Sciences Center, Tucson, Az, USA
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, USA
- Department of Family and Community Medicine, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA
- George Warren Brown School of Social Work, Washington University, St Louis, MO, USA
Diana Cheng
- Department of Emergency Medicine and the Department of Psychiatry, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- Department of Psychology, University of Montreal, Montreal, Canada
- Laboratoire des rêves et des cauchemars, Hôpital Sacré-Coeur, Montreal, Quebec, Canada
- University of Arizona Health Sciences Center, Tucson, Az, USA
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, USA
- Department of Family and Community Medicine, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA
- George Warren Brown School of Social Work, Washington University, St Louis, MO, USA
Tonya Edmond
- Department of Emergency Medicine and the Department of Psychiatry, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- Department of Psychology, University of Montreal, Montreal, Canada
- Laboratoire des rêves et des cauchemars, Hôpital Sacré-Coeur, Montreal, Quebec, Canada
- University of Arizona Health Sciences Center, Tucson, Az, USA
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, USA
- Department of Family and Community Medicine, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA
- George Warren Brown School of Social Work, Washington University, St Louis, MO, USA

Abstract

A descriptive, hypothesis-generating study was performed with 156 female sexual-assault survivors who suffered from insomnia, nightmares, and posttraumatic stress disorder (PTSD). They completed 2 self-report sleep questionnaires to assess the potential presence of intrinsic sleep disorders. Seventy-seven percent of the sample (120 of 156) endorsed additional sleep complaints, besides their insomnia symptoms, that indicate the potential presence of sleep-disordered breathing ([SDB] 81 of 156, 52%) and sleep-related movement disorders ([SMD] 94 of 156, 60%). The potential for SDB was strongly correlated with the body mass index (BMI), an increase in arousal symptoms, and greater total PTSD severity. In some sexual-assault survivors, the relationship between sleeplessness and posttraumatic stress may be caused or exacerbated by intrinsic sleep disorders, and not be solely a function of psychophysiological insomnia—the traditional diagnostic term usually offered to explain the sleep problems associated with PTSD. Prevalence studies that use objective diagnostic evaluations such as polysomnography (PSG) are needed to test these hypotheses.

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☆ Supported by a grant from the National Institute of Mental Health (MH 53239) and the Research Allocation Committee of the University of New Mexico School of Medicine.

PII: S0010-440X(00)90131-7

« Previous Next »Comprehensive Psychiatry
Volume 41, Issue 1 , Pages 49-56, January 2000

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