Bidirectional associations between daily PTSD symptoms and sleep disturbances: A systematic review

Slavish, Danica C.; Briggs, Madasen; Fentem, Andrea; Messman, Brett; Contractor, Ateka A.

doi:10.1016/j.smrv.2022.101623

Cited by 45 publications

(30 citation statements)

References 92 publications

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“…Sleep problems accompany many other types of psychological distress [ 10 , 11 ]. A recently published systematic review reported an interrelationship between insomnia and post-traumatic stress disorder (PTSD) [ 50 ]. Additionally, evidence from prospective studies has shown a bidirectional association between insomnia and other physical (e.g., headache, asthma) or mental (e.g., anxiety, depression) health problems [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with insomnia and suicidal thoughts among outpatients, healthcare workers, and the general population in Taiwan during COVID-19 pandemic: a cross-sectional study

et al. 2022

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Background Insomnia and suicidal thoughts are two of the negative impacts that have been caused by the COVID-19 pandemic. Identifying the factors that contribute to these psychological problems may help develop strategies to sustain the mental health of the public. The present study examined the psychosocial impacts caused by the COVID-19 pandemic among different populations in Taiwan, and investigated the relationships between these psychosocial variables, insomnia, and suicidal thoughts. Methods Between September 2020 and May 2021, online questionnaires including psychometrically validated scales were distributed to a convenience sample of outpatients (n = 205), healthcare workers (HCWs) (n = 500), and individuals in the general population (n = 1200) in Taiwan to collect data regarding their insomnia severity, suicidal thoughts, fear of COVID-19, trust of information, and resilience. Multivariate logistic regression methods were used to identify variables associated with suicidal thoughts and insomnia. Results Greater fear of COVID-19 was significantly associated with suicidal thoughts: odds ratios (ORs) with 95% confidence interval (CI) = 1.155 (1.002–1.330) for outpatients; 1.127 (1.035–1.228) for HCWs; and 1.100 (1.130–1.222) for those in the general population. Higher resilience was significantly associated with lower insomnia: OR (95% CI) = 0.819 (0.725–0.926) for outpatients; 0.803 (0.728–0.887), for HCWs; 0.829 (0.785–0.875), and for those in the general population. In addition, there was a statistically significant association between insomnia diagnosis and greater fear of COVID-19 among HCWs (OR [95% CI] = 1.102 [1.062–1.144]) and those in the general population (OR [95% CI] = 1.079 [1.053–1.106]). Among outpatients, there was a statistically significant association between suicidal thoughts and lower trust of information (OR [95% CI] = 0.794 [0.646–0.976]), while among those in the general population there was a statistically significant association between suicidal thoughts and higher insomnia severity (OR [95% CI] = 1.175 [1.13–1.222]). A statistically significant association was also found between insomnia diagnosis and higher suicidal thoughts among those in the general population (OR [95% CI] = 3.455 [2.338–5.106]). Conclusions Trust of information, fear, and resilience were important factors for suppressing suicidal thoughts and insomnia among the three study populations. Health policies that monitor psychological status and build resiliency of the public are recommended to help develop tailored strategies for different populations affected by the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Factors associated with insomnia and suicidal thoughts among outpatients, healthcare workers, and the general population in Taiwan during COVID-19 pandemic: a cross-sectional study

et al. 2022

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“…These often consist of elevated nocturnal autonomic nervous system arousal ( Kobayashi et al, 2014 ), more stage 1 sleep, less slow wave sleep, and greater rapid-eye movement density ( Kobayashi et al, 2007 ). While most research has considered how PTSD affects sleep, a recent review examining daily studies of sleep and PTSD symptomatology indicates that shorter sleep and poorer sleep quality predict next day PTSD symptoms, suggesting that the relationship between PTSD symptoms and sleep may be bidirectional ( Slavish et al, 2022 ). Given these sleep abnormalities, both subthreshold PTSS and full PTSD may worsen the sleep disturbances that HCWs experience as a result of their profession ( El-Gabalawy et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Examining the prevalence and health impairment associated with subthreshold PTSD symptoms (PTSS) among frontline healthcare workers during the COVID-19 pandemic

Hruska

Patterson

Doshi

et al. 2023

Journal of Psychiatric Research

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“…Prior studies investigating the daily dynamic variations of PTSS have shown greater daily fluctuations in negative affect in individuals with PTSD as compared to healthy controls (Dornbach-Bender et al, 2020 ) as well as circadian patterns in the occurrence of intrusive memories (Rosi-Andersen et al, 2022 ). Heightened PTSS are associated with a variety of negative health outcomes including increased substance use (Buckner et al, 2018 ; Possemato et al, 2015 ), affective symptoms (Dornbach-Bender et al, 2020 ; Greene, 2021 ; Van Voorhees et al, 2018 ), and disrupted sleep (Slavish et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Sleep and day-to-day PTSD symptom variability: an ecological momentary assessment and actigraphy monitored study in trauma-exposed young adults

Schenker

Theoswin

Qian

et al. 2023

European Journal of Psychotraumatology

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Background: Disrupted sleep and post-traumatic stress disorder (PTSD) are bi-directionally linked and have been found to mutually reinforce each other on a day-to-day basis. However, most of the previous research has focused on subjective measures of sleep only. Objective: Here, we investigated the temporal relationship between sleep and PTSD symptoms using both subjective (sleep diary) and objective measures of sleep (actigraphy). Methods: Forty-one non-treatment seeking, trauma exposed young adults (age M = 24.68, SD = 8.15) with a range of PTSD symptom severities (PTSS, 0–53 on PCL-5) were recruited. Participants completed two surveys per day over four weeks to measure day-time PTSD symptoms (i.e. PTSS and number of intrusions) and night-time sleep subjectively, while wearing an actigraphy watch to measure sleep objectively. Results: Linear mixed models revealed that subjectively reported sleep disruptions were associated with elevated next-day PTSS and increasing number of intrusive memories both within and between participants. Similar results were found for daytime PTSD symptoms on night-time sleep. However, these associations were not found using objective sleep data. Exploratory moderator analyses including sex (male vs. female) found that these associations differed in strength between sexes but were generally in the same direction. Discussion: These results were in line with our hypothesis with regards to the sleep diary (subjective sleep), but not actigraphy (objective sleep). Several factors which have implications on both PTSD and sleep, such as the COVID-19 pandemic and/ or sleep-state misperception, may be potential reasons behind those discrepancies. However, this study had limited power and needs to be replicated in larger samples. Nonetheless, these results add to the current literature about the bi-directional relationship between sleep and PTSD and have clinical implications for treatment strategies.

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Bidirectional associations between daily PTSD symptoms and sleep disturbances: A systematic review

Cited by 45 publications

References 92 publications

Factors associated with insomnia and suicidal thoughts among outpatients, healthcare workers, and the general population in Taiwan during COVID-19 pandemic: a cross-sectional study

Factors associated with insomnia and suicidal thoughts among outpatients, healthcare workers, and the general population in Taiwan during COVID-19 pandemic: a cross-sectional study

Examining the prevalence and health impairment associated with subthreshold PTSD symptoms (PTSS) among frontline healthcare workers during the COVID-19 pandemic

Sleep and day-to-day PTSD symptom variability: an ecological momentary assessment and actigraphy monitored study in trauma-exposed young adults

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