Sleep & Breathing
June 26, 2026
James R. Kang, Zahari N. Tchopev, H Samuel Scheuller et al.
Background: Nightmare disorder (NDO) is a clinically under-recognized sleep disorder within the military population. We have previously reported that 31.2% of patients referred to our sleep disorders center incidentally had probable NDO, yet only 3.9% were specifically referred for NDO. Under-recognition and therefore under-treatment of NDO negatively impacts patients' health and military...
Journal of Clinical Sleep Medicine
January 22, 2026
Amanda Radtke, Zahari N. Tchopev, Philip Cushman et al.
Nightmare Disorder (NDO) is an underdiagnosed sleep disorder causing significant impairment, particularly in active duty U.S. military personnel who experience unique stressors. Despite 59.28% of referred service members reporting nightmares and 19.76% screening positive for probable NDO, baseline diagnosis rate was only 0.60%. Our quality improvement project aimed to improve identification and...
Sleep
May 1, 2025
Amanda Radtke, Aaron Burch, James R. Kang et al.
Nightmare Disorder (NDO) is estimated to impact at least 4% of the US adult population yet is reported to be much higher among service members (SMs). Our Center has previously reported 31.2% of referred SMs had probable NDO based on screening measures, yet only 3.9% reported nightmares as a reason for evaluation. No quality measures report on the rate of confirmed diagnosis, and more...
Sleep
May 1, 2025
James R. Kang, Zahari N. Tchopev, H. Scheuller et al.
Nightmare disorder (NDO) is a significant but often under-recognized condition, especially within the military population. We previously reported that 31.2% of patients referred to our military sleep disorders center have NDO, yet only 3.9% were referred for NDO. Despite the general population’s NDO prevalence (2-8%), our center had no referrals for NDO from June 1 to August 31, 2024. This...
Sleep
May 1, 2023
Zahari N. Tchopev, Brent Jacobus, Shana L. Hansen et al.
Abstract Introduction The incidence of nightmares and dreams during clinically indicated polysomnography (PSG) is rarely reported. We sought to (1) describe the incidence of nightmares and dreams during PSG, (2) PSG characteristics of nightmares and dreams, and (3) identify clinical correlates. Methods Ninety-three patients undergoing an initial clinically indicated PSG had a post-PSG and...
Sleep
May 1, 2023
Zahari N. Tchopev, Brent Jacobus, S. Hansen et al.
The incidence and clinical significance of nightmares is difficult to estimate due to varying criteria across studies. The Nightmare Disorder Index (NDI) is a validated measure to evaluate nightmare disorder. However, there is no measure to differentiate trauma-related nightmares compared to trauma associated sleep disorder (TSD), a unique REM parasomnia. The objectives of this study were to...
Sleep
May 1, 2023
Brent Jacobus, Zahari N. Tchopev
Trauma associated sleep disorder (TSD) manifests with trauma-related nightmares, disruptive nocturnal behaviors (DNB), and autonomic hyperactivity. Although patients with TSD frequently report DNB, events are infrequently identified during in-lab polysomnography (PSG), possibly due to a sense of safety imparted by a monitored environment. It is unknown if patients with TSD acclimate to the lab...