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

      Affiliations

    • Corresponding Author InformationAddress 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

      Affiliations

    • 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

      Affiliations

    • 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

      Affiliations

    • 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

      Affiliations

    • 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

      Affiliations

    • 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

      Affiliations

    • 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

      Affiliations

    • 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

References 

  1. Brett E, Spitzer R, Williams J. DSM-III-R criteria for post-traumatic stress disorder. Am J Psychiatry. 1988;145:1232–1236
  2. Frank E, Anderson P. Psychiatric disorders in rape victims: past history and current symptomatology. Compr Psychiatry. 1987;28:77–82
  3. Green B, Lindy J, Grace M. Posttraumatic stress disorder: toward DSM-IV. J Nerv Merit Dis. 1985;173:406–411
  4. Horowitz M. Stress Response Syndrome. New York, NY: Aronson; 1976;
  5. Rothbaum BO, Foa EB, Riggs DS, Murdock T, Walsh W. A prospective examination of post-traumatic stress disorder in rape victims. J Trauma Stress. 1992;5:455–475
  6. Burgess A, Holmstrom L. Rape trauma syndrome and posttraumatic stress response. In: Ed. 2.  Burgess AW editors. Rape and Sexual Assault: A Research Handbook. New York, NY: Garland; 1985;
  7. Herman J. Trauma and Recovery. New York, NY: Basic Books; 1992;
  8. Inman DJ, Silver SM, Doghramji K. Sleep disturbances in posttraumatic stress disorder: a comparison with non-PTSD insomnia. J Trauma Stress. 1990;3:429–437
  9. Hartmann E. The Nightmare: The Psychology and Biology of Terrifying Dreams. New York, NY: Basic Books; 1984;
  10. Ross RJ, Ball WA, Dinges DF, Kribbs NB, Morrison AR, Silver SM, et al.  REM sleep disturbance in PTSD. Biol Psychiatry. 1994;35:195–202
  11. Ross RJ, Ball WA, Sullivan KA, Caroff SN. Sleep disturbance as the hallmark of posttraumatic stress disorder. Am J Psychiatry. 1989;146:697–707
  12. Guerrero J, Crocq MA. Sleep disorders in the elderly: depression and post-traumatic stress disorder. J Psychosom Res. 1994;38(1 Suppl):141–150
  13. Solomon S, Gerrity E, Muff A. Efficacy of treatments for posttraumatic stress disorder: an empirical review. JAMA. 1992;268:633–638
  14. Shalev A, Bonne O, Eth S. Treatment of posttraumatic stress disorder: a review. Psychosom Med. 1996;58:165–182
  15. Resick PA, Schnicke MK. Treating symptoms of adult victims of sexual assault. J Interpers Violence. 1990;5:488–506
  16. Foa EB, Meadows EA. Psychosocial treatments for posttraumatic stress disorder: critical review. Annu Rev Psychol. 1997;48:449–480
  17. Dement WC. Wake Up America: A National Sleep Alert, Executive Summary and Executive Report. In: Ed. 2. Report of the National Commission on Sleep Disorders Research. Washington, DC: National Institutes of Health, US Department of Health and Human Services; 1994;
  18. Dagan Y, Lavie P. Sleep apnea syndrome in war-related PTSD victims. Sleep Res. 1991;20:178; (abstr)
  19. Schenck CH, Boyd JL, Mahowald MW. A parasomnia overlap disorder involving sleepwalking, sleep terrors, and REM sleep behavior disorder in 33 polysomnographically confirmed cases. Sleep. 1997;20:972–981
  20. Mellman TA, David D, Kulick-Bell R, Hebding J, Nolan B. Sleep disturbance and its relationship to psychiatric morbidity after Hurricane Andrew. Am J Psychiatry. 1995;152:1659–1663
  21. Brown TM, Boudewyns PA. Periodic limb movements of sleep in combat veterans with posttraumatic stress disorder. J Trauma Stress. 1996;9:129–135
  22. Keefauver SP, Guilleminault C. Sleep terrors and sleepwalking. In:  Kryger MH,  Roth T,  Dement WC editor. Principles and Practice of Sleep Medicine.. Ed. 2. Philadelphia, PA: Saunders; 1994;
  23. Hauri P, Linde S. No More Sleepless Nights. New York, NY: Wiley; 1990;
  24. Morin C. Insomnia Psychological Assessment and Management. New York, NY: Guilford; 1993;
  25. Glaubman H, Mikulincer M, Porat A, Wasserman O, Birgir M. Sleep of chronic post-traumatic patients. J Trauma Stress. 1990;3:255–263
  26. Guilleminault C. Clinical features and evaluation of obstructive sleep apnea. In:  Kryger MH,  Roth T,  Dement WC editor. Principles and Practice of Sleep Medicine. Ed. 1. Philadelphia, PA: Saunders; 1989;
  27. Krakow B, Tandberg D, Cutchen L, McBride L, Hollifield M, Lauriello J, et al.  Imagery rehearsal treatment of chronic nightmares in PTSD: a controlled study. Sleep Res. 1997;26:245; (abstr)
  28. Buysse D, Reynolds C, Monk T, Berman S, Kupfer D. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193–213
  29. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–1235
  30. Foa E, Riggs D, Dancu C, Rothbaum B. Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. J Trauma Stress. 1993;6:459–473
  31. American Sleep Disorders Association . Practice parameters for the indications for polysomnography and related procedures. Sleep. 1997;20:406–422
  32. Guilleminault C, Stoohs R, Clerck A, Cetel M, Maistros P. A cause of excessive daytime sleepiness: the upper airway resistance syndrome. Chest. 1993;104:781–787
  33. Kryger MH. Management of obstructive sleep apnea: overview. In:  Kryger MH,  Roth T,  Dement WC editor. Principles and Practice of Sleep Medicine. Ed. 2. Philadelphia, PA: Saunders; 1994;
  34. Aldrich MS. Cardinal manifestations of sleep disorders. In:  Kryger MH,  Roth T,  Dement WC editor. Principles and Practice of Sleep Medicine. Ed. 2. Philadelphia, PA: Saunders; 1994;
  35. Kump K, Whalen C, Tishler P, Browner I, Ferrette V, Strohl K, et al.  Assessment of the validity and utility of a sleep-symptom questionnaire. Am J Respir Crit Care Med. 1994;150:735–741
  36. Monplaisir J, Godbout R, Pelletier G, Warnes H. Restless legs syndrome and periodic limb movements during sleep. In:  Kryger MH,  Roth T,  Dement WC editor. Principles and Practice of Sleep Medicine. Ed. 2. Philadelphia, PA: Saunders; 1994;
  37. Walters AS. Clinical features of restless legs syndrome and periodic limb movement in sleep. Advances in Diagnosis and Treatment of the Restless Legs Syndrome and Periodic Limb Movements in Sleep. In: 11th Annual Meeting of the Association of Professional Sleep Societies. 1997 June 10; San Francisco, CA
  38. American Sleep Disorders Association . In: Ed. 2. International Classification of Sleep Disorders. Diagnostic and Coding Manual. Lawrence, KS: Allen Press; 1990;
  39. SAS Institute . SAS System. Cary, NC: SAS Institute; 1990;
  40. Espie CA. The Psychological Treatment of Insomnia. New York, NY: Wiley; 1991;
  41. Partinen M. Epidemiology of sleep disorders. In:  Kryger MH,  Roth T,  Dement WC editor. Principles and Practice of Sleep Medicine. Ed. 2. Philadelphia, PA: Saunders; 1994;
  42. Reynold CF, Coble PA, Spiker DG, Neil JF, Holzer BC, Kupfer DJ. Prevalence of sleep apnea and nocturnal myoclonus in major affective disorders: clinical and polysomnographic findings. J Nerv Ment Dis. 1982;170:565–567
  43. Sullivan CE, Issa FG, Berthon-Jones M, Eves L. Reversal of OSA by continuous positive airway pressure applied through the nares. Lancet. 1981;1:862–865
  44. Lowe AA. Dental appliances for the treatment of snoring and obstructive sleep apnea. In:  Kryger MH,  Roth T,  Dement WC editor. Principles and Practice of Sleep Medicine. Ed. 2. Philadelphia, PA: Saunders; 1994;
  45. Lugaresi E, Cirignotta F, Montagna P, Sforza E. Snoring: pathogenic, clinical, and therapeutic aspects. In:  Kryger MH,  Roth T,  Dement WC editor. Principles and Practice of Sleep Medicine. Ed. 2. Philadelphia, PA: Saunders; 1994;
  46. Powell NB, Guilleminault C, Riley RW. Surgical therapy for OSA. In:  Kryger MH,  Roth T,  Dement WC editor. Principles and Practice of Sleep Medicine. Ed. 2. Philadelphia, PA: Saunders; 1994;
  47. Youakim JM, Dogrhamji K, Schutte SL. Posttraumatic stress disorder and obstructive sleep apnea. Psychosomatics. 1998;39:168–171
  48. Krakow B, Lowry C, Germain A, Gaddy L, Hollifield M, Koss M, et al. Improvement in nightmares and posttraumatic stress disorder following treatment for co-morbid sleep-disorded breathing. Submitted.
  49. Koss M, Burkhart B. A conceptual analysis of rape victimization long-term effects and implications for treatment. Psychol Women Q. 1989;13:27–40
  50. Gidycz C, Koss M. Predictors of long-term sexual assault trauma among a national sample of victimized college women. Violence Vict. 1991;6:175–190
  51. Kilpatrick DG, Saunders BE, Amick-McMullan A, Best CL, Veronen LJ, Resnick HS. Victim and crime factors associated with the development of crime-related post-traumatic stress disorder. Behav Ther. 1989;20:199–214
  52. Van der Kolk BA. Psychological Trauma. Washington, DC: American Psychaiatric Press; 1987;
  53. Krakow B, Kellner R, Pathak D, Lambert L. Imagery rehearsal treatment for chronic nightmares. Behav Res Ther. 1995;33:837–843

 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

Comprehensive Psychiatry
Volume 41, Issue 1 , Pages 49-56 , January 2000