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Sleep loss is threat to vets with PTSD

This article first appeared in the St. Louis Beacon, Sept. 19, 2012 - The greatest danger to the veteran with post-traumatic stress disorder is loss of sleep.

“There is nothing more fundamental to the successful recovery of a combat veteran after war than the ability to get adequate, good quality sleep,” says Dr. Jonathan Shay, a psychiatrist.

He says sleep loss causes irritability and propensity to anger, which are classic symptoms of combat veterans suffering psychological injury.

Shay says Prazocin, a 50-year-old medicine for high blood pressure, has been shown to be very effective in tiny doses in alleviating combat nightmares.

“About half of the veterans who take it say that their nightmares are gone, and another quarter will say, ‘Well doc, I’m still having the dreams, but at least I can get back to sleep,’” he says.

The VA has begun conducting clinical trials of Prazocin at 13 of its medical centers and expects to complete its study sometime in 2012. 

Shay says sleep is fuel for the frontal lobes of the brain, which is where the capacity for emotional and ethical self-restraint lies.

“Sleep is crucial. When you’re totally out of gas in your frontal lobes, you become a moral moron and a lot of the misconduct of combat veterans, I believe, is driven by this measure of frontal lobe function due to sleep loss,” he says.

He says one of the complications of sleep loss is that veterans will drink alcohol to put themselves to sleep.

“It is a very common way that the veteran’s feet get placed on the icy stairway to alcohol abuse and dependency when they try to use alcohol to get to sleep,” he says.

Shay says alcohol is a poor choice as a sedative because the body metabolizes it rapidly and tolerance develops quickly. Veterans who use it to induce sleep will wake up unrested and more wired than before, he says.

“I’ve no religious scruples against alcohol, but I can tell you its pharmacology is satanic,” he says.

Sharon Wittke is a student as in the School of Journalism at Southern Illinois University at Carbondale. She served 25 years in the United States Air Force before retiring last year as a lieutenant colonel. These stories are part of a project of Midwest journalism schools, the Investigative Journalism Education Consortium.  For other stories in this series, see IJEC.org.