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    Prior sleep problems and adverse post-traumatic neuropsychiatric sequelae (APNS) of motor vehicle collision in the AURORA study

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    Authors
    Neylan, Thomas C.
    Kessler, Ronald C.
    Haran, John P
    UMass Chan Affiliations
    Department of Emergency Medicine
    Document Type
    Journal Article
    Publication Date
    2020-09-25
    Keywords
    Insomnia
    Major Depressive Episode
    Motor Vehicle Collision
    Nightmares
    Posttraumatic Stress Disorder
    Prospective Design
    Sleep Stress Reactivity
    Emergency Medicine
    Mental and Social Health
    Psychiatry and Psychology
    
    Metadata
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    Link to Full Text
    https://doi.org/10.1093/sleep/zsaa200
    Abstract
    STUDY OBJECTIVES: Many patients in Emergency Departments (ED) after motor vehicle collisions (MVC) develop posttraumatic stress disorder (PTSD) or major depressive episodes (MDE). This report from the AURORA study focuses on associations of pre-MVC sleep problems with these outcomes 8 weeks after MVC mediated through peritraumatic distress and dissociation and 2-week outcomes. METHODS: 666 AURORA patients completed self-report assessments in the ED and at 2 and 8 weeks after MVC. Peritraumatic distress, peritraumatic dissociation and pre-MVC sleep characteristics (insomnia, nightmares, daytime sleepiness and sleep duration in the 30 days before the MVC, trait sleep stress reactivity) were assessed retrospectively in the ED. The survey assessed acute stress disorder (ASD) and MDE at 2 weeks and at 8 weeks assessed PTSD and MDE (past 30 days). Control variables included demographics, MVC characteristics, and retrospective reports about PTSD and MDE in the 30 days before the MVC. RESULTS: Prevalence estimates were 41.0% for 2-week ASD, 42.0% for 8-week PTSD, 30.5% for 2-week MDE, and 27.2% for 8-week MDE. Pre-MVC nightmares and sleep stress reactivity predicted 8-week PTSD (mediated through 2-week ASD) and MDE (mediated through the transition between 2-week and 8-week MDE). Pre-MVC insomnia predicted 8-week PTSD (mediated through 2-week ASD). Estimates of population attributable risk suggest that blocking effects of sleep disturbance might reduce prevalence of 8-week PTSD and MDE by as much as one-third. CONCLUSIONS: Targeting disturbed sleep in the immediate aftermath of MVC might be one effective way of reducing MVC-related PTSD and MDE.
    Source

    Neylan TC, Kessler RC, Ressler KJ, Clifford G, Beaudoin FL, An X, Stevens JS, Zeng D, Linnstaedt SD, Germine LT, Sheikh S, Storrow AB, Punches BE, Mohiuddin K, Gentile NT, McGrath ME, van Rooij SJH, Haran JP, Peak DA, Domeier RM, Pearson C, Sanchez LD, Rathlev NK, Peacock WF, Bruce SE, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Harte SE, Elliott JM, Hwang I, Petukhova MV, Sampson NA, Koenen KC, McLean SA. Prior sleep problems and adverse post-traumatic neuropsychiatric sequelae (APNS) of motor vehicle collision in the AURORA study. Sleep. 2020 Sep 25:zsaa200. doi: 10.1093/sleep/zsaa200. Epub ahead of print. PMID: 32975289. Link to article on publisher's site

    DOI
    10.1093/sleep/zsaa200
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29694
    PubMed ID
    32975289
    Notes

    Full author list omitted for brevity. For the full list of authors, see article.

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    Link to Article in PubMed

    ae974a485f413a2113503eed53cd6c53
    10.1093/sleep/zsaa200
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