Impact of Sleep Disturbances on Post-Traumatic Stress Disorder Symptoms and Perceived Health Geneviève Belleville1,2, Stéphane Guay2, & André Marchand1,2 1Université du Québec à Montréal; 2Centre de Recherche Fernand-Seguin, Hôpital Louis-H. Lafontaine PSQI Total Score INTRODUCTION RESULTS 70% of individuals with Post-Traumatic Stress Disorder (PTSD) report significant sleep difficulties. Disturbed sleep has been associated with more severe PTSD symptoms. However, the relationship between sleep and PTSD symptom severity may be mediated by other factors associated with trauma as well as with sleep disturbances, such as: - Psychiatric comorbidity (e.g., Major Depressive Disorder) - Health status - Alcohol use and abuse - Use of psychotropic medication Hierarchical Multiple Regressions Block 1: Sociodemographic variables Block 2: Characteristics of trauma Block 3: Psychiatric comorbidities and substance use Block 4 : Sleep Dependent variable: PTSD Symptom Severity Predictors β sr2 R2 ∆ R2 1. Gender NS Age Marital status 2. Months since trauma # of traumas 3. Major Depressive Disorder .424* .450* .300* .280* Anxiety Disorder Alcohol -.210* -.238* Psychotropic Medication 4. Sleep .366* .384* .385* .084* OBJECTIVES 1. To assess the specific influence of sleep disturbances on PTSD symptom severity and perceived health 2. To explore clinical correlates of sleep disturbances in PTSD METHOD Dependent variable : Perceived Physical Health Participants : 92 volunteer treatment-seeking adults with PTSD 66 women (72%) Aged from 18 to 68 years (mean = 39.57, SD = 12.94). 52% were employed (with 29% on sick leave) 48% were either married or in a common-law relationship 56% had a college education or higher PTSD diagnosis was rated as moderate (31%) or severe (57%) Types of reported trauma associated with the development of PTSD included: - Physical aggression or threats (35%) - Vehicle accidents (27%) - Witnessing an event that happened to others (15%) - Sexual aggression (9%) - Marital violence (7%) * Predictors β sr2 R2 ∆ R2 1. Gender NS Age Marital status 2. Months since trauma # of traumas 3. Major Depressive Disorder Anxiety Disorder Alcohol Psychotropic Medication 4. Sleep .051* * * p < .05 DISCUSSION The following data were collected during a pre-treatment assessment : Dependent variable: Perceived Mental Health Disturbed sleep has a unique, negative impact on PTSD symptom severity. 8.4% of PTSD symptom severity variance was independently accountable by sleep disturbances. Disturbed sleep negatively influences how PTSD patients perceive their own mental health. 4.9% of perceived mental health was independently accountable by sleep disturbances. Sleep disturbances were more severe only among PTSD patients with multiple psychiatric comorbidities and among those using psychotropic medication, but did not differ as a function of gender, age, marital status, time interval since trauma or type of trauma. In clinical settings, it appears essential to investigate for sleep disturbances with every PTSD patients, as most of them have poor sleep quality, which is, in turn, susceptible to worsen their condition. More research is currently being carried out to document the impact of cognitive-behavior treatment of PTSD on sleep disturbances. Variables Measures Psychiatric Diagnoses Diagnostic Interview (SCID-IV) Sociodemographic variables and use of psychotropic medication Intake Interview Post-traumatic symptom severity Modified PTSD Symptom Scale – Self-Report Sleep Quality Pittsburgh Sleep Quality Index (PSQI) Perceived Physical Health SF-12 : Physical Health Component Score Perceived Mental Health SF-12: Mental Health Component Score Alcohol Use Questionnaire on Alcohol Use Predictors β sr2 R2 ∆ R2 1. Gender NS .067* .101* Age .239* .240* Marital status 2. Months since trauma # of traumas 3. Major Depressive Disorder -.404* -.411* .210* .192* Anxiety Disorder Alcohol Psychotropic Medication 4. Sleep -.260* -.265* .255* .049* * p < .05