When Don Bankosh sleeps these days, he often sees "snapshots" of wounded soldiers or Iraqi children with missing limbs.

For two years after his 2004 return from Iraq, he slept a mere 2¹/₂ to 4 hours a night. To this day, the slightest noise awakens him, and a fire whistle makes him sit straight up in bed.

Some nights he awakens drenched in sweat, and only the next day does he remember what war-borne nightmare caused the ordeal.

Mr. Bankosh is 100 percent disabled from a medical condition he said was aggravated by his deployment in Iraq, coupled with post-traumatic stress disorder. As an Army staff sergeant with the 101st Airborne Division, he participated in the Iraqi invasion and its aftermath.

"I think I'll have to deal with this the rest of my life," said Mr. Bankosh, 39, of Crabtree, Westermoreland County.

Many returning veterans suffer from insomnia and nightmares. Sleep problems also can affect returning veterans without PTSD or post-war adjustment problems.

So the University of Pittsburgh has launched three studies designed to help returning veterans with sleep disorders.

Pitt's Clinical Neuroscience Research Center is recruiting veterans for the studies designed to show which sleep treatments work best, how the sleeping brain works in veterans with PTSD and how best to restore veterans' bio-rhythmic clocks upon their return to civilian life.

Veterans returning from Iraq or Afghanistan can participate in the Pitt studies by calling 412-246-6409.

"A lot do have PTSD, but a lot do not have it, but they still have severe nightmares and insomnia," said principal investigator Anne Germain, assistant professor of psychiatry at the University of Pittsburgh School of Medicine.

The first study will determine whether medical or nonmedical treatments work best for military veterans. The medication Prazosin, which reduces nightmares and insomnia, is thought to work by reducing a derivative of adrenalin, and thus tension, stress and anxiety.

Nonmedical treatments include dream therapy to eliminate nightmares, which "become almost like a habit after one is exposed to stressful life events," Dr. Germain said.

Insomnia can be treated with a sleep regimen matching one's needs.

"We're having good results with all of these," Dr. Germain said, noting investigators hope to determine which treatment or combination is optimal.

PTSD is a stress disorder based on normal human reactions when exposed to abnormal or extreme events or perceived or real threats, she said. It becomes a psychological problem when those reactions persist for months or years.

Dr. Germain said 20 percent of people deployed to Iraq and Afghanistan return with PTSD, and another 20 percent suffer psychological or behavioral effects that can cause readjustment problems as civilians.

Sleep problems are a natural consequence of combat.

"Some start sleeping during the day when they feel safe, and feel a duty and responsibility to watch over the family [at night]," Dr. Germain said. "It's as though they're not able to get out of the pattern that what was good for survival in a combat environment is costly in civilian life."

For the first study, veterans will undergo two weeks of evaluation and a sleep study followed by eight weeks of treatment. The goal is "effective treatments that target sleep problems" common in returning veterans that clinicians and doctors can use, Dr. Germain said.

Lack of sleep can aggravate other physical and psychological problems veterans experience, by making them irritable and unable to focus, she said.

The university soon will begin recruiting returning veterans for an imaging study of brain patterns before and after treatment in an effort to better understand the biology of PTSD. "We will look into people's brains when they are sleeping to see what is different in PTSD that causes nightmares and insomnia," Dr. Germain said.

In a final study, Pitt will help veterans without PTSD to restore sleep patterns after experiencing months of disruptive and irregular sleep during deployment.

The Department of Defense has provided $2.5 million to fund the first two studies, with the National Institute of Mental Health providing about $400,000 for the third study.

"If people sleep better and don't have nightmares, their emotional health and performance the next days is drastically improved," Dr. Germain said. "When sleep is considered as part of a treatment plan, outcomes will be better and persist over time."

Daniel Ziff, a licensed social worker with the PTSD clinical team with the Veterans Administration in Pittsburgh, said the studies are right on target. Sleep, he said, is "probably the most paramount feature" in a veteran's readjustment problems and can lead to various problems, including suicide. Survival habits learned in combat do not fit the civilian world.

"We're really fortunate to have Dr. Germain and her team in Pittsburgh," Mr. Ziff said. "This is one slice of the pie, but an important slice of the pie."

Mr. Bankosh, who said the Veterans Administration has helped him deal with his problems, said his wartime deployment in Iraq took its toll -- a toll with which, he said, every soldier must contend. He said he plans to sign up for the study.

"If you try to hide from it, it's a time bomb. It will explode," he said. "It's a very humbling experience. I'll just leave it at that."