Quality of sleep in patients with posttraumatic stress disorder

Abstract

Objective. To assess the characteristics and correlates of sleep problems in patients with lifetime posttraumatic stress disorder and ongoing sleep disturbance not due to obstructive sleep apnea or other diagnosed sleep disorders.Sample. Twenty-six veterans receiving psychiatric care at the Minneapolis Veterans Affairs Medical Center in Minneapolis, Minnesota.Data collection instruments. The Pittsburgh Sleep Quality Index, sleep logs, and actigraph along with three symptom ratings scales-posttraumatic checklist, clinician-administered posttraumatic stress disorder scale, and Beck Depression Inventory-were used.Results. Univariate analysis associated three symptom complexes with poorer sleep quality: posttraumatic avoidance, posttraumatic hypervigilance, and depressive symptoms. Borderline trends also existed between worse sleep quality and more severe clinician-rated posttraumatic stress, more self-reported awakenings from sleep, and greater actigraphy-determined sleep duration. Using linear regression, only posttraumatic hypervigilance symptoms were associated with sleep quality.Conclusion. Sleep quality among posttraumatic stress disorder patients in active treatment is worse in direct relation to more severe posttraumatic hypervigilance symptoms.

Keywords: actigraphy; daytime sleepiness; posttraumatic stress disorder; veteran.