Sleep Quality Affects Cognitive Functioning in Returning Combat Veterans Beyond Combat Exposure, PTSD, and Mild TBI History
Sleep Quality Affects Cognitive Functioning in Returning Combat Veterans Beyond Combat Exposure, PTSD, and Mild TBI History
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DOI：
10.1037/neu0000312
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发表时间：
2017-01-01
期刊：
影响因子：
2.4
通讯作者：
Dolan, Sara L.
中科院分区：
文献类型：
--
作者：
Martindale, Sarah L.;Morissette, Sandra B.;Dolan, Sara L.
目的：本研究的目的是在考虑了战斗暴露、创伤后应激障碍（PTSD）和轻度创伤性脑损伤（mTBI）史的影响后，确定睡眠质量如何影响退伍军人的认知功能。方法：这是一项横断面评估研究，评估战斗暴露、创伤后应激障碍、mTBI病史、睡眠质量和神经心理功能。109名符合条件的伊拉克/阿富汗男性退伍军人完成了一项评估，包括结构化的临床访谈、神经心理学测试和自我报告测量。结果：采用偏最小二乘结构方程模型，战斗经历和mTBI病史与睡眠质量无直接关系。创伤后应激障碍与睡眠质量直接相关，睡眠质量会导致神经心理功能的缺陷，除了战斗经历、创伤后应激障碍和mTBI病史外，还会导致神经心理功能的缺陷。战斗经历和创伤后应激障碍与运动速度有不同的联系。结论：睡眠对认知功能的影响与战斗经历、创伤后应激障碍和mTBI病史无关。除了创伤后应激障碍的影响外，睡眠质量也会导致认知缺陷。睡眠质量的评估可能是一个有用的点，临床干预作战退伍军人的认知投诉。改善睡眠质量可以减轻认知疾病，提高退伍军人参与治疗的能力。
Objective: The purpose of this study was to determine how sleep quality affects cognitive functioning in returning combat veterans after accounting for effects of combat exposure, posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI) history. Method: This was a cross-sectional assessment study evaluating combat exposure, PTSD, mTBI history, sleep quality, and neuropsychological functioning. One hundred and nine eligible male Iraq/Afghanistan combat veterans completed an assessment consisting of a structured clinical interview, neuropsychological battery, and self-report measures. Results: Using partial least squares structural equation modeling, combat experiences and mTBI history were not directly associated with sleep quality. PTSD was directly associated with sleep quality, which contributed to deficits in neuropsychological functioning independently of and in addition to combat experiences, PTSD, and mTBI history. Combat experiences and PTSD were differentially associated with motor speed. Conclusions: Sleep affected cognitive function independently of combat experiences, PTSD, and mTBI history. Sleep quality also contributed to cognitive deficits beyond effects of PTSD. An evaluation of sleep quality may be a useful point of clinical intervention in combat veterans with cognitive complaints. Improving sleep quality could alleviate cognitive complaints, improving veterans' ability to engage in treatment.