Sleep and resilience: a longitudinal 37-year follow-up study of Vietnam repatriated prisoners of war

This study examined sleep histories associated with resilience after trauma defined as a continuous lack of psychiatric illness across 37 years. Data were drawn from a 37-year follow-up examination of the effects of the Vietnam prisoner of war (POW) experience. The Robert E. Mitchell Center for POW Studies is a unique institution holding the only longitudinal study of the effects of the American POW experience in existence. The study used a sample of 440 Vietnam repatriated prisoners of war (RPWs). Psychiatric disorders were assessed at repatriation (1973) and were continued annually by a psychiatrist or clinical psychologist. Sleep issues before, during, and after captivity were assessed upon repatriation during medical examinations. Odds ratios examining presence of sleep symptoms show resilient RPWs reporting fewer symptoms compared to nonresilient RPWS before, during, and after captivity. Logistic regression comparing before, during, and after indicates fewer reported sleep disturbance symptoms after captivity was the strongest predictor of resilience (b = -0.82, Wald chi2 (1) = 16.70, p < 0.000). Reporting fewer sleep complaints, but not necessarily an absence of them before, during, and after the trauma predicts resilience across time.