Nightly Sleep Disruption Predicts Next-Day PTSD Symptoms: A Pilot Ecological Momentary Assessment Study in Sexual Assault Survivors With and Without PTSD.

Abstract

Sleep disruption is a hallmark feature of posttraumatic stress disorder (PTSD). Studies using ecological momentary assessment suggest sleep disruption predicts next-day PTSD symptoms, though evidence for the reverse effect is inconsistent. We examined bidirectional associations between subjective sleep and PTSD symptom severity in a pilot sample of sexual assault survivors with and without PTSD (N = 35). Participants completed a sleep diary each morning and self-report measures of PTSD symptom severity and negative affect 3 times/day for 1 week. Multilevel models revealed that shorter sleep duration and longer sleep onset latency significantly predicted higher PTSD symptoms the following day, controlling for prior PTSD symptoms and negative affect (p's < 0.05). In contrast, tests of reverse models revealed no significant associations between daytime PTSD symptoms and subsequent sleep disruption on any sleep outcome (p's > 0.05). These findings suggest night-to-night disruptions in sleep may signal risk for increased PTSD symptoms. Implications for targeting sleep to treat PTSD symptoms are discussed.