Insomnia Precipitating Events among Women Veterans: The Impact of Traumatic and Nontraumatic Events on Sleep and Mental Health Symptoms

Abstract

ABSTRACT Objective/Background The current study describes insomnia precipitating events reported by women Veterans and examines differences in sleep and psychological distress variables in those who endorsed traumatic, nontraumatic, or no insomnia precipitating events. Participants Baseline data were collected from 347 women Veterans enrolled in a behavioral sleep intervention study (NCT02076165). Methods Participants completed self-report measures of insomnia symptoms, sleep quality, sleep efficiency (SE), nightmare frequency, and depression and posttraumatic stress disorder (PTSD) symptoms; SE was also assessed by wrist actigraphy. Participants responded to 2 open-ended questions assessing stressful life events and health changes that coincided with insomnia symptom onset. Responses were coded as traumatic, nontraumatic, and no events. Analyses of covariance examined the effect of insomnia precipitating event type on sleep and psychological symptom variables after controlling for sociodemographic factors. Results Overall, 25.80% of participants endorsed traumatic events, 65.80% endorsed only nontraumatic events, and 8.41% endorsed no events. Participants who endorsed traumatic events reported more severe insomnia (p = .003), PTSD (p = .001), and depression symptoms (p = .012), and poorer quality of sleep (p = .042) than participants who endorsed no events. Participants who endorsed traumatic events reported more severe PTSD symptoms (p = .004), a longer duration of sleep problems (p = .001), and poorer quality of sleep (p = .039) than participants who endorsed nontraumatic events. Participants who endorsed nontraumatic events reported more severe insomnia (p = .029) and PTSD (p = .049) symptoms than participants who endorsed no events. Conclusions Trauma as a precipitant for insomnia may be related to higher symptom severity in women Veterans. Implications for treatment engagement and effectiveness remain unstudied.