Sleep disturbances are prominent features of post-traumatic syndromes. There is evidence that sleep loss may exacerbate or predispose to psychiatric disorders. Post-disaster studies indicate varying risk for psychiatric morbidity. We postulate persisting sleep disturbance to be a marker and possible mediator of increased risk. Hurricane Andrew has been characterized as the most extensive natural disaster in United States history. Most victims are likely to have experienced sleep disruption. We plan to recruit subjects with continuing sleep distur- bance, initially provoked by the hurricane, and a comparison group of victims without persisting sleep impairment. Subjects will be evaluated cross-sectionally to determine how sleep disturbance, psychiatric symptoms and disorders, and known psychiatric risk factors are associated in the wake of a disaster; and longitudinally to assess the risk of worsening symptoms and new onset disorders associated with persisting sleep disturbance. In order to provide validation of subjective reports of disturbed sleep, a sub-group of subjects will be evaluated in the sleep laboratory. Laboratory evaluations and longitudinal follow up will be expanded in future studies.
