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Cited by 63Sleep and related disordersSleep and Wakefulness ResearchPosttraumatic Stress Disorder Research

Nightmares in United States military personnel with sleep disturbances

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Creamer, Jennifer L., Brock, Matthew S., Matsangas, Panagiotis, Motamedi, Vida, Mysliwiec, Vincent·2018·Journal of Clinical Sleep Medicine
DOI 10.5664/jcsm.6990PMC PMC5837843
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Abstract

Study objectives Sleep disturbances are common in United States military personnel. Despite their exposure to combat and trauma, little is known about nightmares in this population. The purpose of this study was to describe the prevalence and associated clinical and polysomnographic characteristics of nightmares in United States military personnel with sleep disturbances. Methods Retrospective review of 500 active duty United States military personnel who underwent a sleep medicine evaluation and polysomnography at our sleep center. The Pittsburgh Sleep Quality Index and the Pittsburgh Sleep Quality Index-Addendum were used to characterize clinically significant nightmares. Subjective and objective sleep attributes were compared between groups. Results At least weekly nightmares were present in 31.2%; yet, only 3.9% reported nightmares as a reason for evaluation. Trauma-related nightmares occurred in 60% of those patients with nightmares. Patients with nightmares had increased sleep onset latency (SOL) and rapid eye movement (REM) sleep latency (mean SOL/REM sleep latency 16.6/145 minutes, P = .02 and P = .01 respectively) compared to those without (mean SOL/REM sleep latency 12.5/126 minutes). The comorbid disorders of depression (P ≤ .01, relative risk [RR] 3.55 [95% CI, 2.52-4.98]), anxiety (P ≤ .01, RR 2.57 [95% CI, 1.93-3.44]), posttraumatic stress disorder (P ≤ .01, RR 5.11 [95% CI, 3.43-7.62]), and insomnia (P ≤ .01, RR 1.59 [95% CI, 1.42-1.79]) were all associated with nightmares. Conclusions Clinically significant nightmares are highly prevalent in United States military personnel with sleep disturbances. Nightmares are associated with both subjective and objective sleep disturbances and are frequently comorbid with other sleep and mental health disorders. Commentary A commentary on this article appears in this issue on page 303.

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  • Reduced nightmares per week may be related to increased total sleep time.

    “Reduced nightmares per week may be related to increased total sleep time, as previous studies demonstrate that nightmares are more frequent when patients are sleep deprived (Creamer, Brock, Matsangas, Motamedi, & Mysliwiec, 2018; Tamanna, Parker, Lyons, & Ullah, 2014).”

    From Benefits of Cognitive Behavioral Therapy for Insomnia for Women Veterans with and without Probable Post-Traumatic Stress Disorder (2022) · cites this paper as Creamer, Brock, Matsangas, Motamedi, & Mysliwiec, 2018

    The Discussion reports that shorter self-reported sleep time and more frequent nightmares occurred together in findings from Vietnam veterans, which supports a possible relationship. But it does not establish that sleep deprivation makes nightmares more frequent; the paper also proposes the reverse direction, with nightmares contributing to sleep deprivation. (LLM, conf=0.81)

    Experimental — accuracy not yet measured

  • Nightmares are more frequent when patients are sleep deprived.

    “as previous studies demonstrate that nightmares are more frequent when patients are sleep deprived (Creamer, Brock, Matsangas, Motamedi, & Mysliwiec, 2018; Tamanna, Parker, Lyons, & Ullah, 2014).”

    From Benefits of Cognitive Behavioral Therapy for Insomnia for Women Veterans with and without Probable Post-Traumatic Stress Disorder (2022) · cites this paper as Creamer, Brock, Matsangas, Motamedi, & Mysliwiec, 2018

    The Abstract reports that insomnia was associated with nightmares, and the Discussion reports shorter self-reported sleep in the trauma-related nightmare group than in the nightmare-disorder-only group. These findings support a relationship between nightmares and poor sleep, but the paper does not demonstrate that being sleep deprived makes nightmares more frequent; the Discussion instead raises the possibility that nightmares contribute to sleep deprivation. Page numbers were not available in our copy. (LLM, conf=0.86)

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Authors
Creamer, J. L., Brock, M. S., Matsangas, P., Motamedi, V., & Mysliwiec, V.
Affiliations
  • United States Army (US)
  • Brooke Army Medical Center (US)
  • Naval Postgraduate School (US)
  • National Institutes of Health (US)
Corresponding author
Creamer, Jennifer L.
ORCID
Venue
Journal of Clinical Sleep Medicine
Publisher
Springer Science and Business Media LLC
Published
2018-03-15
Volume
14
Issue
3
Pages
419-426
ISSN
  • 1550-9389 (ISSN-L)
  • 1550-9397
DOI
10.5664/jcsm.6990
PMC
PMC5837843
OpenAlex
W2792543204
Cited by
63
References
8
Citations by year
2026: 8 · 2025: 5 · 2024: 7 · 2023: 9 · 2022: 7 · 2021: 5 · 2020: 7 · 2019: 4 · 2018: 10 · 2017: 1
FWCI
8.51
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Sleep Medicine (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Calhoun: The Naval Postgraduate School Institutional Archive (Naval Postgraduate School) (submittedVersion, public-domain)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Keywords
nightmares, military personnel, sleep disorders, trauma-related nightmares, post-traumatic stress disorder, insomnia, depression, anxiety, sleep latency, REM latency, comorbidities
MeSH terms
Adult, Anxiety, Depression, Dreams, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Military Personnel, Surveys and Questionnaires, Retrospective Studies, Sleep Wake Disorders, Stress Disorders, Post-Traumatic, United States, Prevalence, Polysomnography

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