0812 Nightmares: An Independent Risk Factor For Cardiovascular Disease

Abstract

Introduction

Associations between PTSD, sleep and cardiovascular disease are well-established in prior research, but few studies have examined adverse health correlates of nightmares. Nightmares are often called the “hallmark” symptom of PTSD and represent the cardinal sleep-specific manifestation of PTSD. Yet, prior studies have not examined nightmares’ independent contribution to cardiovascular disease risks beyond risks conferred by PTSD. The purpose of this study was to examine associations between nightmares and cardiovascular disease in Veterans with and without PTSD.

Methods

Participants were Veterans (N=3876; 78% male) serving since September 11, 2001, 1 or 2 tours of duty (73.5%), aged 38 years (SD=10.4), 31% meeting criteria for current PTSD, with equivalent proportions of African-Americans (48%) and Caucasians (48%). Nightmare frequency was assessed using the Davidson Trauma Scale (DTS), with “frequent” defined as occurring at least 2-3 times per week. Self-reported medical issues were assessed using the National Vietnam Veterans Readjustment Study (NVVRS) Self-report Medical Questionnaire. PTSD diagnosis was established using the Structured Clinical Interview for DSM-V.

Results

Frequent nightmares over the past week were endorsed by 33% of participants. Cardiovascular conditions were endorsed at the following rates: heart problems (6%); diabetes (6.6%); arthrosclerosis (0.5%); hypertension (29.2%); stroke (0.7%); and heart attack (1.2%). After adjusting for age, sex and race, frequent nightmares were associated with heart problems (F=7.50, p=.006), high blood pressure (F=23.84, p<.0001), and heart attack (F=7.19, p=.007). When PTSD was added to the model, these associations remained significant.

Conclusion

We found that frequent nightmares among Veterans are associated with cardiovascular conditions, even after controlling for the effects of PTSD. Additional research is needed to explore mechanisms explaining these associations and determine if reducing nightmare frequency and severity results in improved cardiovascular health.

Support

This work was supported by the Department of Veterans VISN 6 MIRECC and ADAPT Centers at the Durham VA Health Care System. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.