1. mail: lkosinska@wim.mil.pl
Nightmares in Polish Military Contingents veterans with PTSD and non-PTSD diagnosis Kosińska L, Ilnicki P, Tworus R Military Institute of Medicine, Department of Psychiatry and Combat Stress Warsaw, ul. Szaserów 128, Poland
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INTRODUCTION
Sleep disorders in the form of nightmares are often an outcome of a trauma experienced. They were many times described in veterans - participants of missions in war operations areas, mainly with post-traumatic stress disorder (PTSD) diagnosis. Posttraumatic dreams can be replicative, partly similar to traumatic event or have only a symbolic association with the trauma.
A nightmare classified within parasomnia is defined as a „frightening dream that usually awakens the sleeper”.
In terms of their frequency of occurrence nightmares can be divided into:
Mild nightmares - occurring not more often than once a week;
Moderate nightmares - occurring more often than once a week;
Severe nightmares – occurring many times during a night.
„I see terrorists. I have an order to shoot them dead. They are preparing an ambush for us. Finally I’m firing at them. I’m killing them all. I come closer, take a look and they are my brother’s kids and my doughter…”
GOAL 
The goal of this study was an assessment of frequency of occurrence of sleep disorders in the form of nightmares in veterans of Polish military deployments abroad and also an assessment of differences in their occurrence in a group with PTSD diagnosis and a group with another diagnosis.
MATERIAL AND METHOD
The study included 31 males in the age ranging from 22 to 55 years, veterans of deployments within the Polish Military Contingent in Iraq and Afghanistan, hospitalised in our Department of Psychiatry and Combat Stress.
They had been deployed from one to six times. The subjects were split into two groups:
- 14 subjects diagnosed with PTSD;
- 17 subjects with another diagnosis (non-PTSD): adaptive disorder – 8, neurosis disorder - 5, personality disorder - 2 and alcohol addiction - 2. There were no significant difference between these groups in terms of age and number of deployments.
The Sleep Quality Questionnaire and individual interview were used for detection of sleep disorders.
Information on nightmares occurrence, obtained by means of the questionnaire and the interview were ranked in terms of their occurrence frequency and content. Nightmare frequency was analysed in two categories: no nightmares at all and the presence of nightmares. In addition an increased intensity of nightmares occurrence was considered; an occurrence of nightmares more often than once a week was used as a criterion (moderate nightmare disorder and severe nightmare disorder ). In terms of content the nightmares were divided into those with a mission-related content and idiopatic ones (without mission-related content).
RESULTS
Nightmares of various content and frequency including mild, moderate and severe ones occurred in 27 subjects (87%). In the group of subjects with PTSD nightmares occurred in 12 veterans (86%), and in the non-PTSD group - in 15 veterans (88%).
Statistically no difference was found between both examined groups (χ2 with Yates’ correction: χ2=0.11; p=SI).
Moderate and severe nightmares occurred in 20 veterans (65%). In the PTSD group in 8 subjects (57%), and in the non-PTSD group in 12 subjects (71%).
Also in this case no significant difference in occurrence frequency for moderate and severe nightmares between the examined groups was found (χ2 with Yates’ correction: χ2=0.16; p=SI).
Content of nightmares
In the PTSD group in 92% of the veterans nightmares’ content was related to deployment situation. Nightmares of both types: those related to deployment and unrelated ones occurred in 8% of the subjects with PTSD. In the non-PTSD group 60% of veterans experienced nightmares with mission-related content, 20% had non- mission- related content and 20% had both types. In many cases dreams contained distorted elements or concerned additional facts reported by veteran colleagues.
CONCLUSIONS
Often occurrence of nightmares (87%) was found in the examined group of veterans.
There is no statistically significant difference in occurrence of nightmares in veterans with PTSD diagnosis comparing to those with another diagnosis.
In most of the veterans the content of their nightmares was connected with their deployment.
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