New Sleep Disorder Discovered - Combat Soldiers

[lcurle]

The study of a series of patients at Madigan Army Medical Center here, has led doctors to discover a new unique sleep-related condition impacting combat Soldiers called Trauma-associated Sleep Disorder.

“Redeployed military personnel have reported for the last 13 years complex nighttime behaviors ranging from sleepwalking, tossing and turning, thrashing, screaming, and even hitting their bed partners,” said Col. (Dr.) Vincent Mysliwiec, principal investigator and lead author, and U.S. Army Medicine sleep medicine specialist. “While these disruptive nocturnal behaviors are frequently reported, they are rarely documented in laboratory settings.”

Although previous authors recognized some of the unique sleep disturbances seen in combat survivors, the constellation of findings of disruptive nocturnal behaviors, nightmares and rapid eye movement, or REM, sleep without atonia had never been linked together. There was no current diagnosis which encompassed all these trauma engendered sleep disturbances.

Atonia is also known as sleep paralysis, which occurs when a person suddenly finds himself or herself unable to move for a few minutes, most often upon falling asleep or waking up. Sleep paralysis is due to an irregularity in passing between the stages of sleep and wakefulness.

“Up until this time, it was unknown what military personnel and trauma survivors had in terms of a clinical disorder,” said Mysliwiec. “In many cases they were diagnosed with nightmare disorder, which does not have movements associated with this diagnosis, or REM Behavior Disorder, which occurs in middle-aged to elderly males and has a characteristic clinical presentation. This case series highlights the unique findings of TSD (Trauma-associated Sleep Disorder).”

The case series included four Soldiers who had been evaluated, diagnosed and treated at Madigan. Each Soldier underwent a clinical evaluation in the hospital’s sleep medicine clinic and was given an attended, overnight polysomnogram (sleep study). The polysomnogram recorded body functions, such as heart rate, brain waves, movements and any sounds they made during sleep.

According to published results, all of the young men developed disruptive nighttime behaviors and nightmares after suffering a traumatic experience. Some reported screaming and combative movements, while others experienced night sweats and crying episodes throughout the night.

“Normally individuals in REM sleep are paralyzed and do not move, thus they are unable to act out their dreams. Patients with TSD appear to have dream enactment, with purposeful movements that can occur in REM sleep,” said Mysliwiec. “This case series is a major step forward in not only diagnosis and treatment of military personnel with sleep disturbances, but also sleep safety for families.”

In addition to providing trauma survivors with the understanding that they have a clinical diagnosis, this case study also helps facilitate future research in the sleep disturbances that develop after trauma.

“Better characterization of the clinical findings is required, especially in regards to the onset of TSD and how much REM without atonia is present,” said Mysliwiec. “Prospective studies are required to evaluate treatment regimens, as many service members and veterans have findings of TSD.”

This case series appears online and in print this month in the Journal of Clinical Sleep Medicine, the official publication of the American Academy of Sleep Medicine.

Read more: http://www.defencetalk.com/new-sleep-disorder-discovered-impacting-combat-soldiers-60940/#ixzz3I6uGhuHI

[Gastone]

Icurle: What did you claim as a Nexus for your SA? Did you see an Non VA sleep Neurologist? Were you DX'd with PTSD before the SA?

Nam Vet 70% SC PTSD DX 2011 50% SC M-SA secondary to CAD. VA likes to attribute your SA to porking up and 171/2+ neck. A Very Good non VA Sleep Neurologist gave me a DBQ with the magic words, "MORE LIKELY THAN NOT" M-SA DX 2010 due to CAD DX 2006.

I trust your Denied claims are alive on appeal, don't miss your NOD Deadline.

Semper Fi

Gastone

[Berta]

This study is VERY interesting.

I wonder if it will make a difference to the VA but sleep disturbances are symptomatic to PTSD and part of that rating criteria.

I certainly feel that any disturbed sleep patterns, to include SA,cvan have a profound affect on the mental and physical well being of any veteran.

Thanks for posting this.

[lcurle]

Since I had no SC or anything in my SMR in regards to sleep apnea it was denied, I have my PTSD tied up in appeals right now. I will wait to claim SA against once I delve more into the cause of it. From what I gather, the onset was after the burn pits in Afghanistan. Also waiting on my Gulf War Registry and Burn Pit Registry exam.

[ArNG11]

Since I had no SC or anything in my SMR in regards to sleep apnea it was denied, I have my PTSD tied up in appeals right now. I will wait to claim SA against once I delve more into the cause of it. From what I gather, the onset was after the burn pits in Afghanistan. Also waiting on my Gulf War Registry and Burn Pit Registry exam.

Same story here, except I don't officially claim or have been diagnosed with PTSD from the VA. Personally and several studies can give figures that many Veterans that worked or were stationed near bases and posts that had burn pits develop breathing problems such as sleep apnea and among other things. The problem is that like myself these symptoms don't develop right away. If they are not annotated in your SMR's you typically get denied, even if you develop symptoms and are diagnosed with sleep apnea you are denied, at times even when it's in your SMR's. A good nexus and a specific timeline and documented medical evidence is your real hope to get service connected for this high ticket item.

[lcurle]

It developed a few years after I got out, nothing documented about it after deployment in my SMR. So no chance in that getting SC'ed

[Chuck75]

"Trauma-associated Sleep Disorder."

I'd go further and say that the Navy's watch system can/is a major contributor to sleep disorders.

Seems that many of the smaller vessels use a system that causes the assigned watch times to rotate

in reference to the time of day/night.

This rotation really screws you up, as it causes major conflicts with the usual circadian rhythms.

Common watch schemes go from "watch on watch", or 4 hours on, 4 off, to 4 on 24 off.

4 on 12 off was a common one, with 4 on 16 off an improvement. When off time coincided

with the "normal" workday, the watch stander also had to work normal hours. The watch stander

might also have to provide relief for the follow on watch when meal times were involved.