Diapositive 1

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
RESULTS
INTRODUCTION

• 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 ß sr2 R2 ? R2
1. Gender NS NS NS NS
1. Age NS NS NS NS
1. Marital status NS NS NS NS
2. Months since trauma NS NS NS NS
2. of traumas NS NS NS NS
3. Major Depressive Disorder .424 .450 .300 .280
3. Anxiety Disorder NS NS .300 .280
3. Alcohol -.210 -.238 .300 .280
3. Psychotropic Medication NS NS .300 .280
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 ß sr2 R2 ? R2
1. Gender NS NS NS NS
1. Age NS NS NS NS
1. Marital status NS NS NS NS
2. Months since trauma NS NS NS NS
2. of traumas NS NS NS NS
3. Major Depressive Disorder NS NS NS NS
3. Anxiety Disorder NS NS NS NS
3. Alcohol NS NS NS NS
3. Psychotropic Medication NS NS NS NS
4. Sleep NS NS NS .051
p lt .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 ß sr2 R2 ? R2
1. Gender NS NS .067 .101
1. Age .239 .240 .067 .101
1. Marital status NS NS .067 .101
2. Months since trauma NS NS NS NS
2. of traumas NS NS NS NS
3. Major Depressive Disorder -.404 -.411 .210 .192
3. Anxiety Disorder NS NS .210 .192
3. Alcohol NS NS .210 .192
3. Psychotropic Medication NS NS .210 .192
4. Sleep -.260 -.265 .255 .049
p lt .05