Temporal sequence and relationships between sleep disorders, mental disorders and traumatic brain injury in deployed military members / Pamela Herbig Wall.

Format:

Book

Manuscript

Thesis/Dissertation

Author/Creator:

Wall, Pamela Herbig, author.

Contributor:

Richmond, Therese S., degree supervisor.

Hanrahan, Nancy, degree committee member.

Gerhman, Phil, degree committee member.

University of Pennsylvania. Department of Nursing.

Language:

English

Subjects (All):

Penn dissertations--Nursing.

Nursing--Penn dissertations.

Local Subjects:

Penn dissertations--Nursing.

Nursing--Penn dissertations.

Physical Description:

ix, 157 leaves ; 29 cm

Production:

[Philadelphia, Pennsylvania] : [University of Pennsylvania], 2014.

Summary:

U.S. military members are often forward deployed to austere environments where they are exposed to environmental, mental, and physiological stressors that can negatively affect their wellbeing and readiness for service. These service members are at high risk for developing sleep disorders, mental disorders, and traumatic brain injury (TBI) that may produce functional disability and further erode mission readiness. While there is ample evidence on distinct relationships between these three clusters of disorders, relatively few studies examine all three in a military and/or veteran population. Health care providers in the United States Military need information about these complex interactions in order to determine risk for future disease or injury and to ensure that those who are sent to austere environments have the ability to adapt to stress and adversity. The purpose of this retrospective study was to determine temporal patterns and relationships between sleep disorders, mental disorders, and TBI in service members who were deployed from 2001 to 2011. To fulfill this purpose, longitudinal medical surveillance data from two electronic medical charting systems that included over 288,000 deployed service members with a diagnosed sleep disorder were used. A series of descriptive statistics, logistic regression analysis, and Chi-square tests for independence were used to answer the research questions. Results showed that insomnia, sleep disordered breathing, substance use disorders and adjustment disorders occurred most frequently in this sample and that pre-existing sleep disorders are predictive of mental disorders after deployment but TBI was not. Those with TBI are diagnosed most frequently with insomnia and parasomnias, and temporally, mental disorders usually precede a sleep disorder diagnosis. The findings of this study have expanded the work of previous researchers in the area of mental disorders, sleep disorders and TBI in deployed military service members, and may help reduce risk for future disease and provide critical information to guide policy regarding military readiness and suitability for future deployments. Future research is needed to identify emergence of the symptoms of disease, identify best practices for sleep disorder treatment, and a comprehensive assessment of TBI and comorbid disorders in a military population.

Notes:

Ph. D. University of Pennsylvania 2014.

Department: Nursing.

Supervisor: Therese S. Richmond.

Includes bibliographical references.

OCLC:

909959934