The goal of this observational study is to learn about the long-term health of United States military service members who were injured during combat. The main questions it aims to examine are: * How does the severity of a combat injury impact 1) cardiovascular risk, 2) the sympathetic nervous system and arrhythmias, 3) blood pressure, and 4) sleep disorders? * Are self-reported mental health symptoms related to sympathetic nervous system hyperactivity, sleep disorders, and cardiovascular risk in combat-injured service members? This study will recruit from a sample of participants in another research study called the Wounded Warrior Recovery Project (WWRP) who 1) agreed to be contacted about future research studies and 2) have a record of a combat injury within the Injury Severity Score ranges required for this study. Participants will: * Provide demographic information and a medical history review * Visit a local laboratory for biometrics measurements and to provide blood and urine samples * Wear an ambulatory electrocardiogram monitor for 24 hours per day for seven consecutive days * Wear a home sleep test monitoring device for one night * Wear a blood pressure monitor for 24 consecutive hours on the day after the home sleep test At the end of the study, participants will be asked to mail back the home sleep test and blood pressure monitors. Prepaid package materials will be provided.
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Frequency of arrhythmias
Timeframe: 7 days of wear
Frequency of atrial fibrillation
Timeframe: 7 days of wear
Frequency of atrial flutter
Timeframe: 7 days of wear
Density of premature ventricular contractions (PVCs)
Timeframe: 7 days of wear
Frequency of ventricular tachycardia
Timeframe: 7 days of wear
Heart rate
Timeframe: 7 days of wear
Standard deviation of beat-to-beat intervals (SDNN)
Timeframe: 7 days of wear
Root mean square of successive differences (RMSSD)
Timeframe: 7 days of wear
Low frequency power
Timeframe: 7 days of wear
High frequency power
Timeframe: 7 days of wear
Log-transformed QT variance (logQTv)
Timeframe: 7 days of wear
Beat-to-beat QT variability index (QTVI)
Timeframe: 7 days of wear
Presence of obstructive sleep apnea
Timeframe: One night
Presence of nocturnal hypoxemia
Timeframe: One night
24-hour ambulatory blood pressure monitor (ABPM)
Timeframe: 24 hours
High sensitivity C-reactive protein (hs-CRP)
Timeframe: Baseline
Posttraumatic Stress Disorder Checklist for Diagnostic and Statistics Manual of Mental Disorder 5 (PCL-5)
Timeframe: Baseline
8-item Patient Health Questionnaire depression scale (PHQ-8)
Timeframe: Baseline
Brief Dissociative Experience Scale (DES-B)
Timeframe: Baseline
Pittsburgh Sleep Quality Index (PSQI)
Timeframe: Baseline
Epworth Sleepiness Scale (ESS)
Timeframe: Baseline
Insomnia Severity Index (ISI)
Timeframe: Baseline
Berlin Sleep Questionnaire
Timeframe: Baseline
Body Mass Index
Timeframe: Baseline
Blood Pressure
Timeframe: Baseline
Hemoglobin A1C (HBA1C)
Timeframe: Baseline
Alanine aminotransferase (ALT/SGPT)
Timeframe: Baseline
Albumin:globulin (A:G) ratio
Timeframe: Baseline
Albumin, serum
Timeframe: Baseline
Alkaline phosphatase, serum
Timeframe: Baseline
Aspartate aminotransferase (AST/SGOT)
Timeframe: Baseline
Bilirubin, total
Timeframe: Baseline
Blood urea nitrogen (BUN)
Timeframe: Baseline
Blood urea nitrogen (BUN):creatinine ratio
Timeframe: Baseline
Calcium, serum
Timeframe: Baseline
Carbon dioxide, total
Timeframe: Baseline
Chloride, serum
Timeframe: Baseline
Creatinine, serum
Timeframe: Baseline
Estimated glomerular filtration rate (eGFR) calculation
Timeframe: Baseline
Globulin, total
Timeframe: Baseline
Glucose, serum
Timeframe: Baseline
Potassium, serum
Timeframe: Baseline
Protein, total, serum
Timeframe: Baseline
Sodium, serum
Timeframe: Baseline
Cystatin C with estimated glomerular filtration rate (eGFR)
Timeframe: Baseline
Cholesterol, total
Timeframe: Baseline
High-density lipoprotein (HDL) cholesterol
Timeframe: Baseline
Low-density lipoprotein (LDL) cholesterol (calculation)
Timeframe: Baseline
Triglycerides
Timeframe: Baseline
Very low-density lipoprotein (VLDL) cholesterol (calculation)
Timeframe: Baseline
Albumin/creatinine ratio, random urine
Timeframe: Baseline
N-terminal pro b-type natriuretic peptide (NT-proBNP)
Timeframe: Baseline