Probable trauma-associated sleep disorder among Ukrainian combatants with stress-related mental disorders

The Russian-Ukrainian war has created a mental health crisis among combatants, with sleep disorders representing a critical aspect of combat-related conditions. The objective is to assess the prevalence of insomnia, nightmares, and their association with clinically probable Trauma-Associated Sleep Disorder (TASD) among Ukrainian combatants with stress-related mental disorders. This cross-sectional study included 99 male combatants (aged 18-59) undergoing inpatient treatment for stress-associated disorders (adjustment disorder, n = 36; PTSD, n = 63). Assessments included psychiatric interviews using ICD-10 criteria, the Insomnia Severity Index, Hamburg Nightmare Questionnaire, and TASD symptom assessment. Clinically significant insomnia was observed in 77.8 % of individuals with adjustment disorder and 82.5 % with PTSD (p = 0.562). Nightmares were reported by 86.1 % and 90.5 %, respectively (p = 0.533). Probable TASD criteria were met by 80.6 % of those with adjustment disorder and 84.1 % with PTSD (p = 0.650). Combatants with clinically significant insomnia had a 2.5 times higher risk of developing TASD compared to those without insomnia (RR = 2.55, 95 % CI 1.41-4.60, p < 0.001), with this relationship persisting after adjusting for confounding factors. This study demonstrates a high prevalence of probable TASD among Ukrainian combatants with both PTSD and adjustment disorders. The strong association between insomnia and TASD underscores the importance of insomnia as a clinical marker for TASD screening in combatants with stress-associated disorders.