Affiliation:
1. Laboratory of Epidemiology and Population Sciences NIA/NIH/IRP Baltimore Maryland USA
2. Department of Psychiatry Yale School of Medicine New Haven Connecticut USA
3. US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder VA Connecticut Healthcare System West Haven Connecticut USA
4. US Department of Veterans Affairs National Center for Posttraumatic Stress Disorder VA White River Junction Healthcare System White River Junction Vermont USA
5. Veterans Affairs Connecticut Healthcare System West Haven Connecticut USA
6. Department of Social and Behavioral Sciences Yale School of Public Health New Haven Connecticut USA
Abstract
SummaryMilitary veterans have high rates of psychiatric conditions such as posttraumatic stress disorder, which can complicate the clinical management of insomnia. Population‐based data are lacking on the prevalence, characteristics and mental health burden of veterans with co‐occurring posttraumatic stress disorder and insomnia. The current cross‐sectional study analysed data from a nationally representative sample of 4069 US veterans examining the prevalence and comorbidity between posttraumatic stress disorder and insomnia, and their associations with psychiatric and medical comorbidities, suicidality, and psychosocial functioning. Results revealed that 4.0% of US veterans screened positive for posttraumatic stress disorder + insomnia, 7.4% for insomnia only, and 3.2% for posttraumatic stress disorder only. Compared with controls, higher odds of major depressive disorder and generalized anxiety disorder were observed in the posttraumatic stress disorder + insomnia and posttraumatic stress disorder only groups. Moreover, compared with the control group, posttraumatic stress disorder + insomnia and posttraumatic stress disorder only groups had higher odds of current suicidal ideation, while the posttraumatic stress disorder + insomnia group had also higher odds of attempting suicide. Relative to the posttraumatic stress disorder only group, the posttraumatic stress disorder + insomnia group scored substantially lower on measures of cognitive, emotional and social functioning (d = 1.05, 1.04 and 0.87, respectively). This study provides contemporary data regarding current prevalence, correlates, and psychiatric and functional burden of posttraumatic stress disorder + insomnia among US veterans. The results underscore the importance of assessing, monitoring and treating posttraumatic stress disorder and insomnia as part of the efforts to mitigate suicide risk and promote multi‐domain functioning in this population.