Transcultural Psychiatry
Volume 54, Issue 5-6, 2017, Pages 806-823

Treatment of sleep disturbances in refugees suffering from post-traumatic stress disorder (Article)

Sandahl H.* , Vindbjerg E. , Carlsson J.
  • a Competence Centre for Transcultural Psychiatry, Mental Health Services in the Capital Region of Denmark, Denmark
  • b Competence Centre for Transcultural Psychiatry, Mental Health Services in the Capital Region of Denmark, Denmark
  • c Competence Centre for Transcultural Psychiatry, Mental Health Services in the Capital Region of Denmark, Denmark

Abstract

Sleep disturbances are often referred to as the hallmark of Post-Traumatic Stress Disorder (PTSD). Although PTSD is prevalent in refugees, studies on sleep disturbances in trauma-affected refugees are scarce. This article presents the results of two studies: a systematic review of the literature on treatment of sleep disturbances in adult trauma-affected refugees and a study of the role of sleep disturbances in the PTSD symptom structure. Study 1, the literature review, identified five studies on treatment of sleep disturbances: four studies were on pharmacological treatment and one study on music therapy. The identified studies had small sample sizes and few carried out statistical analysis. It was not possible from the available literature to recommend any specific treatment of sleep disturbances. In Study 2, a clinical sample of 752 refugees, fulfilling criteria for PTSD and enrolled in treatment at the Competence Centre for Transcultural Psychiatry, Denmark, completed the Harvard Trauma Questionnaire (HTQ) before and after treatment. To determine item discrimination, the data was tested with a Rasch model. 99.1% reported trouble sleeping and 98.7% reported recurrent nightmares. The Rasch analysis displayed fit residuals of 0.05 for trouble sleeping and –1.16 for nightmares, indicating sufficient discrimination. Trouble sleeping and nightmares proved important parts of the HTQ response structure. This study indicates that sleep disturbances are a prominent part of the PTSD symptom structure in refugees but that research on treatment of sleep disturbances is limited. Further research on sleep disturbances in trauma-affected refugees is therefore needed. © 2017, © The Author(s) 2017.

Author Keywords

Sleep PTSD Post-traumatic stress disorder Refugee

Index Keywords

patient care nightmare music therapy refugee Prazosin complication polysomnography human wellbeing Refugees comorbidity Denmark recurrent disease Sleep Wake Disorders Humans sleep disorder male female Harvard Trauma Questionnaire cultural psychiatry Article sleep quality sleep time adult posttraumatic stress disorder Stress Disorders, Post-Traumatic mental disease assessment disease severity Pittsburgh Sleep Quality Index clonidine systematic review

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85037728035&doi=10.1177%2f1363461517746314&partnerID=40&md5=940d167c11c352bbf6325e7d36780e0b

DOI: 10.1177/1363461517746314
ISSN: 13634615
Cited by: 3
Original Language: English