1. 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