Details

Autor(en) / Beteiligte

• Werner, Gabriela G.
• Göhre, Isabelle
• Takano, Keisuke
• Ehring, Thomas
• Wittekind, Charlotte E.
• Stefanovic, Mina
• Kendall-Tackett, Kathleen

Titel

Temporal Associations Between Trauma-Related Sleep Disturbances and PTSD Symptoms: An Experience Sampling Study

Ist Teil von

• Psychological trauma, 2024-07, Vol.16 (5), p.846-854

Ort / Verlag

United States: Educational Publishing Foundation

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• Objective: There is robust evidence for the influence of sleep disturbances on the maintenance of PTSD symptoms. However, little is known about day-to-day variation in trauma-related sleep disturbances (namely insomnia symptoms and nightmares) and their associations with PTSD symptoms. Therefore, we explored the dynamic interplay of these symptoms in daily life using an experience sampling method (ESM). Method: For 15 consecutive days, participants with PTSD symptomatology as primary complaint (N = 48) reported momentary levels of insomnia symptoms and nightmares as well as PTSD symptoms via a mobile app. Results: Multilevel model analyses revealed that insomnia and nightmares were significant predictors of PTSD symptomatology on the following day; furthermore, nightmares were predictive of each of the four PTSD symptom clusters, namely reexperiencing, avoidance, cognition and hyperarousal as well as symptoms of dissociation. However, PTSD symptoms did not predict insomnia or nightmares during the following night. Multilevel mediation analyses suggested that nightmares mediate the relationship between insomnia and next-day PTSD symptoms. Conclusions: These findings support accumulating evidence that trauma-related sleep disturbances play an important role in the maintenance of PTSD symptoms, by elevating symptoms daily. Clinical Impact Statement The current ESM study showed that insomnia and nightmares significantly predicted next-day PTSD symptoms and that the effect of insomnia on PTSD symptom severity was mediated by nightmares. This may suggest that targeting and improving insomnia and nightmares may have a positive effect on daily PTSD symptomatology. Conversely, there was no change in insomnia or nightmares following days with elevated PTSD symptoms. Therefore, treating insomnia (e.g., through cognitive-behavioral therapy for insomnia [CBT-I]) and nightmares (e.g., imagery rehearsal therapy [IRT]) should become recognized as primary intervention targets in PTSD treatment by research and clinical practice.