Sleep patterns in three acute combat fatigue cases.

A preliminary report is presented on the sleep patterns of three combat fatigued patients with recurrent nightmares, insomnia, low frustration thresholds and impotence. All the patients had undergone acute partial sleep deprivation prior to their breakdown. The results show severe deficiency in REM sleep and absence of stage 4 sleep. EMG was usually high with numerous body movements and bursts of tachycardia throughout the night. Nightmares occurred in stage 2. Total effective sleep time was between 129' and 250'. Most of the sleep was in stage 2, and patients woke up with the feeling that "they had not slept at all." It is hypothesized that acute partial sleep deprivation prior to breakdown was an important predisposing factor, and that chronic partial sleep deprivation was a constant aggravating factor of combat fatigue. Replacement therapy for the specific deficient sleep states is proposed.