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. 2023 Sep;54(5):863-875.
doi: 10.1016/j.beth.2023.03.005. Epub 2023 Mar 29.

Subjective Sleep Disturbances in Sexual Assault Survivors: Associations With Trauma and Posttraumatic Stress Disorder Symptom Severity

Rebecca C Cox  1 , Alexa N Garcia  2 , Sarah C Jessup  2 , Sarah E Woronko  2 , Catherine E Rast  2 , Bunmi O Olatunji  2
Affiliations

Subjective Sleep Disturbances in Sexual Assault Survivors: Associations With Trauma and Posttraumatic Stress Disorder Symptom Severity

Rebecca C Cox et al. Behav Ther. 2023 Sep.

Abstract

Prior work implicates sleep disturbance in the development and maintenance of posttraumatic stress disorder (PTSD). However, the majority of this literature has focused on combat veteran men, and limited work has examined links between sleep disturbance and PTSD symptoms in sexual assault survivors. This is a notable gap in the literature, as sexual trauma is disproportionately likely to result in PTSD and is more common in women. We sought to examine the relations between subjective sleep disturbance, sexual assault severity, and PTSD symptoms in a sample of sexual assault survivors with PTSD (PTSD+), without PTSD (PTSD-), and healthy controls. The sample (N = 60) completed the Insomnia Severity Index and prospectively monitored their sleep for 1 week using the Consensus Sleep Diary. The sexual assault survivors also completed the Sexual Experiences Survey and PTSD Checklist-5. Results of group comparisons found that the PTSD+ group reported significantly higher insomnia symptoms, longer sleep onset latency, more nocturnal awakenings, and lower sleep quality compared to the healthy control group and higher insomnia symptoms compared to the PTSD- group. Results of regression analyses in the sexual assault survivors found that insomnia symptoms and number of nocturnal awakenings were significantly associated with higher PTSD symptoms, and sexual assault severity was significantly associated with higher insomnia symptoms, longer sleep onset latency, and lower sleep quality. These findings highlight specific features of sleep disturbance that are linked to trauma and PTSD symptom severity among sexual assault survivors.

Keywords: PTSD; insomnia; sexual assault; sleep; trauma.

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Conflict of interest statement

Declaration of Interest. None

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.
Group comparisons of insomnia symptoms (panel A), sleep onset latency (panel B), number of awakenings (panel C), and sleep quality (panel D) between sexual assault survivors with PTSD (PTSD+), without PTSD (PTSD−), and healthy controls.
Figure 2.
Figure 2.
Linear regression models for associations between insomnia symptoms (panel A), sleep onset latency (panel B), number of awakenings (panel C), and sleep quality (panel D) and posttraumatic stress disorder (PTSD) symptoms.
Figure 3.
Figure 3.
Linear regression models for associations between sexual assault severity and insomnia symptoms (panel A), sleep onset latency (panel B), number of awakenings (panel C), and sleep quality (panel D).
See this image and copyright information in PMC

References

    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders DSM-5. American Psychiatric Association. In DSM. 10.1176/appi.books.9780890425596.744053 - DOI
    1. Bastien CH, Vallieres A, & Morin CM (2001). Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine, 2, 297–307. 10.1080/15402002.2011.606766 - DOI - PubMed
    1. Belleville G, Guay S, & Marchand A (2009). Impact of sleep disturbances on PTSD symptoms and perceived health. Journal of Nervous and Mental Disease, 197(2), 126–132. 10.1097/NMD.0b013e3181961d8e - DOI - PubMed
    1. Bovin MJ, Marx BP, Weathers FW, Gallagher MW, Rodriguez P, Schnurr PP, & Keane TM (2015). Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans. Psychological Assessment, 25(11), 1379–1391. 10.1037/pas0000254 - DOI - PubMed
    1. Calhoun PS, Wiley M, Dennis MF, Means MK, Edinger JD, & Beckham JC (2007). Objective evidence of sleep disturbance in women with posttraumatic stress disorder. Journal of Traumatic Stress, 20(6), 1009–1018. 10.1002/jts.20255 - DOI - PubMed

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