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This investigation assessed the extent to which various health factors are associated with difficulties initiating and maintaining sleep (DIMS) and nightmares among Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans reporting a trauma (combat, noncombat, or a trauma before service). Veterans (N = 201, 88.1% male, mean age = 34.2, SD = 10.1) were referred by primary care for a behavioral health assessment upon evidence of psychiatric symptoms. Sleep problems were assessed using items from the PTSD checklist. After controlling for demographics and nonsleep PTSD symptoms, head injury with a loss of consciousness increased the likelihood of severe nightmares (OR = 3.77, p = 0.019), alcohol abuse or dependence increased the likelihood of moderate nightmares (OR = 4.80, p = 0.007), and greater nonsleep depression increased the likelihood of severe DIMS (OR = 1.20, p = 0.008). Thus, factors aside from PTSD severity are related to sleep disturbance in OIF/OEF veterans reporting a trauma.
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