The study included almost 4,000 veterans serving one or two tours of duty since September 11, 2001. Previous research has noted relationships between post-traumatic stress disorder (PTSD), sleep, and cardiovascular disease. Sleep-disrupting nightmares, the authors noted, were the “hallmark” symptom of PTSD.
“[P]rior 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.”
The study included 3,876 veterans (78% male). Of those, 31% met the criteria for PTSD [even split between white (48%) and black veterans (48%)]. The researchers used the Davis Trauma Scale and defined “frequent” as at least two to three times per week. Other self-reported medical issues were assessed wit hthe National Vietname Veterans Readjustment Study (NVVRS) Self-report Medical Questionnaire, and PTSD was clinically diagnosed with the Structured Clinical Interview for DSM-V.
According to the results, 33% of patients reported frequent nightmares. The authors reported the rates of multiple cardiovascular conditions (6% for heart problems, 6.6% for diabetes, 0.5% for atherosclerosis, 29.2% for hypertension, 0.7% for stroke, and 1.2% for heart attack. Frequent nightmares were associated with heart problems (P=0.006), high blood pressure (P<0.0001), and heart attacks (P=0.007) after adjustment for age, sex, and race. The associations remained after adding PTSD to the model.
“Our cross-sectional findings set the stage for future research examining the possibility that nightmares may confer cardiovascular disease risks beyond those conferred by PTSD diagnosis alone,” lead investigator Christi Ulmer, a doctor of clinical psychology and clinical research psychologist at the Durham VA Health Services Research and Development ADAPT Center and assistant professor in the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center, said in a news release. “If longitudinal research demonstrates a causal role for nightmares in cardiovascular disease risk, nightmare treatment could be a strategy for improving cardiovascular health.”