Elsevier

Journal of Affective Disorders

Volume 221, 15 October 2017, Pages 25-30
Journal of Affective Disorders

Research paper
Psychiatric disorders moderate the relationship between insomnia and cognitive problems in military soldiers

https://doi.org/10.1016/j.jad.2017.06.023Get rights and content

Highlights

  • Insomnia is highly prevalent in soldiers with current psychiatric disorders.

  • Depression, GAD, and PTSD had the highest prevalence of comorbid insomnia disorder.

  • Depression, PTSD, and GAD moderated the relation between insomnia and cognition.

Abstract

Background

There has been a great deal of research on the comorbidity of insomnia and psychiatric disorders, but much of the existing data is based on small samples and does not assess the full diagnostic criteria for each disorder. Further, the exact nature of the relationship between these conditions and their impact on cognitive problems are under-researched in military samples.

Method

Data were collected from the All Army Study of the Army Study to Assess Risk and Resilience in Service members (unweighted N = 21, 449; weighted N = 674,335; 18–61 years; 13.5% female). Participants completed the Brief Insomnia Questionnaire to assess for insomnia disorder and a self-administered version of the Composite International Diagnostic Interview Screening Scales to assess for psychiatric disorders and cognitive problems.

Results

Military soldiers with current major depressive episode (MDE) had the highest prevalence of insomnia disorder (INS; 85.0%), followed by current generalized anxiety disorder (GAD; 82.6%) and current posttraumatic stress disorder (PTSD; 69.7%), respectively. Significant interactions were found between insomnia and psychiatric disorders; specifically, MDE, PTSD, and GAD status influenced the relationship between insomnia and memory/concentration problems. Limitations: Cross-sectional nature of the assessment and the absence of a comprehensive neurocognitive battery.

Conclusion

Psychiatric disorders moderated the relationship between insomnia and memory/concentration problems, suggesting that psychiatric disorders contribute unique variance to cognitive problems even though they are associated with insomnia disorder. Results highlight the importance of considering both insomnia and psychiatric disorders in the diagnosis and treatment of cognitive deficits in military soldiers.

Section snippets

Method

The data source for the present study was the All Army Study (AAS) of the Army Study to Assess Risk and Resilience in Service members (STARRS). The AAS is a cross-sectional self-administered questionnaire administered between 2011 and 2013. For the current study, participants were a representative sample (unweighted N = 21,449; weighted N = 674,335; 13.5% female) of U.S. Army soldiers recruited in quarterly samples from active duty Army personnel. Each quarterly AAS replicate consisted of a

Results

Participants were military soldiers between the ages of 18 and 61 years (M = 29.5, SD = 7.9). Approximately, 66.3% were White, 16.3% were Black, 3.6% were Asian, 1.0% were Pacific Islanders, 1.3% were American Indian/Alaskan Native, 4.1% were multicultural, and 7.5% were other. About 34.5% completed GED/high school, 32.5% completed technical study/certificate programs, 10.7% completed an associate degree, 14.5% completed a four year degree, and 7.8% completed graduate/professional degrees.

Discussion

The present study examined the prevalence of psychiatric disorders in relation to insomnia disorder in military soldiers, and investigated the role of psychiatric disorders in the relationship between insomnia and cognitive problems. Overall, our findings indicate that insomnia disorder is highly prevalent in military soldiers with current comorbid psychiatric disorders. Specifically, we found that military soldiers with current MDE had the highest prevalence rate of insomnia disorder (85.0%),

Conclusion

Psychiatric disorders moderated the relationship between insomnia disorder and memory and concentration problems. Our results highlight the importance of considering psychiatric disorders in the diagnosis and treatment of cognitive deficits in military soldiers with insomnia disorder, as treatment of insomnia alone may not be enough to improve cognitive functioning in those soldiers with comorbid psychiatric diagnoses. The present study further highlights the need to address both sleep

Role of funding source

This project was funded by the Department of the Army and funded under the cooperative agreement U01MH087981 with the United States Department of Health and Human Services, National Institute of Health, and the National Institute of Mental Health.

Acknowledgements

This publication is based on public use data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). The data are available from the Inter-university Consortium for Political and Social Research (ICPSR) at the University of Michigan (http://doi.org/10.3886/ICPSR35197-v1). Army STARRS was funded by the U.S. National Institute of Mental Health (grant number U01MH087981). The contents of this publication are solely the responsibility of the authors and do not necessarily

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