Correlates of impaired sleep duration among adults with trauma alone and with posttraumatic stress disorder.

Objective: To elucidate the relationship between impaired sleep duration and trauma/posttraumatic stress disorder (PTSD) net of sociodemographic, behavioral, and comorbid diagnostic factors.

Method: We investigated this relationship using the National Epidemiologic Survey on Alcohol and Related Conditions-III data set, analyzing a nationally representative sample of 36,309 adults. Our study identified three groups: those without trauma/PTSD, those with trauma but no PTSD, and those with PTSD. We examined the relationship of impaired sleep duration and trauma/PTSD net of demographic, diagnostic, and behavioral factors in these groups.

Results: Significant differences were observed among the groups across many sociodemographic and behavioral variables. Compared to those without trauma or PTSD, higher odds of reporting impaired sleep duration were observed among those with trauma (odds ratio = 1.38, 95% confidence interval [1.30, -1.47]) and especially those with PTSD (odds ratio = 2.54, confidence interval [2.22, -2.91]). Adjusted multivariable regression revealed attenuated but still significant associations between trauma/PTSD and impaired sleep duration, with PTSD showing a small effect size (> 1.5) on odds of impaired sleep duration and trauma alone showing a less than clinically meaningful effect size (< 1.5 but > 1). Recursive feature elimination identified key predictors of impaired sleep duration, including age, body mass index, race/ethnicity, psychiatric multimorbidity, chronic pain, and medical comorbidity.

Conclusions: Impaired sleep duration among individuals with trauma/PTSD is highly multifactorial. While trauma and PTSD contribute to sleep disturbances, other factors such as psychiatric and medical comorbidities play significant roles; impaired sleep in trauma/PTSD may be better understood through the lens of allostatic load. Addressing these comorbid factors alongside trauma/PTSD may improve treatment outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).