Am J Psychiatry 1991; 148:62-66
Copyright © 1991 by American Psychiatric Association
Sleep disturbances in survivors of the Nazi Holocaust
J Rosen, CF Reynolds 3d, AL Yeager, PR Houck and LF Hurwitz
Geriatric Health Services, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, PA 15213.
OBJECTIVE AND METHOD: Sleep disturbances are commonly reported by victims
of extraordinary stress and can persist for decades. This study was
designed to test the hypothesis that survivors of the Nazi Holocaust would
have significantly more and different sleep problems than depressed and
healthy comparison subjects and that the severity of the survivors'
problems would be correlated with length of time spent in a concentration
camp. Forty-two survivors, 37 depressed patients, and 54 healthy subjects
of about the same age, all living in the community, described their sleep
patterns over the preceding month on the Pittsburgh Sleep Quality Index, a
self-rating instrument that inquires about quality, latency, duration,
efficiency, and disturbances of sleep, use of sleep medication, and daytime
dysfunction. RESULTS: The survivors had significantly greater sleep
impairment than the healthy comparison subjects, as measured by all
subscales of the index, but had less impairment than the depressed patients
except on the sleep disturbances and daytime dysfunction subscales.
However, for specific items within these subscales, survivors had
significantly more frequent awakenings due to bad dreams and had less loss
of enthusiasm than the depressed subjects. Sleep disturbances and frequency
of nightmares were significantly and positively correlated with the
duration of the survivors' internment in concentration camps. CONCLUSIONS:
These findings suggest that for some Holocaust survivors, impaired sleep
and frequent nightmares are considerable problems even 45 years after
liberation.
