Table 1.

Operationalization of trauma associated sleep disorder diagnostic criteria used to identify veterans with probable trauma associated sleep disorder

Trauma associated sleep disorder diagnostic criteria	Measure used to assess	Measure indications for meeting criteria
A. Onset of symptoms after combat or other traumatic experience	TLEQ	Prior traumatic experience
B. History of altered dream mentation that is related to prior traumatic experience	PSQI-A	Trouble sleeping because of memories or nightmares of a traumatic experience†
C. Self or witness reports of disruptive nocturnal behaviors involving one of the following: 1.Abnormal vocalizations a.moaning, screaming, or yelling 2.Abnormal motor behaviors in sleep: a.tossing, turning, or thrashing b.combative behaviors such as striking bedpartner	PSQI-A	Trouble sleeping because of one or more of the following: 1.Episodes of terror or screaming during sleep without fully awakening† 2.Episodes of “acting out” dreams, such as kicking, running, or screaming†
D. Symptoms of autonomic hyperarousal or polysomnographic monitoring that demonstrates at least one of the following associated with dream mentation: 1.Tachycardia, 2.Tachypnea, or 3.Diaphoresis	PSQI-A	Trouble sleeping because of one or more of the following: 1.Feeling hot flashes† 2.Feeling general nervousness† 3.Severe anxiety or panic, not related to traumatic memories†
E. Absence of EEG epileptiform activity on polysomnography and the disturbance is not better explained by another sleep disorder, medical disorder, medication, or substance use*	Polysomnography	Not available in this study

^† Occurring ≥1 time per week in the past month (scoring PSQI-A item ≥2).

^* Sensitivity analyses were performed to remove individuals with a history of self-reported epilepsy in the past 12 months and substance use.

^‡EEG = electroencephalogram; TLEQ = Traumatic Life Events Questionnaire; PSQI-A = Pittsburgh Sleep Quality Index with Addendum for Posttraumatic Stress Disorder.