1. In this study, baseline poor sleep was associated with more severe PTSD symptoms longitudinally.
2. Furthermore, this relationship between poor sleep and more severe PTSD symptoms was moderated by perceived pandemic-related threat.
Evidence Rating Level: 2 (Good)
The COVID-19 pandemic has claimed over 4 million lives globally and heightened levels of stress, psychiatric, and post-traumatic stress disorder (PTSD) symptoms among individuals. Poor sleep quality and perceived threat have been shown to contribute to and worsen PTSD symptoms. Furthermore, poor sleep quality may be of particular importance in the context of perceived threat. This observational study investigated associations between self-reported sleep quality and anticipated threat appraisals of the pandemic among adults with PTSD for 6 months.
In this study, 590 adult participants affected by trauma and PTSD were included from all 50 states in the United States of America through online forums. PTSD symptoms and their severity levels were assessed at baseline and after 30 days (via 20 items PTSD Checklist-5) for the participants; the same longitudinal evaluation was performed for sleep quality. Participants further rated the threat of the pandemic to domains of life such as work and finances, education and training, social relationships inside and outside the home, and physical and emotional health in the next 12 months.
Results demonstrated that participants generally rated their sleep quality as “fair” at baseline. They also reported mild to moderate anticipatory threat appraisals of the pandemic at baseline. However, worse baseline sleep quality correlated with more severe PTSD symptoms at the 30-day follow-up, particularly in those who perceived the pandemic as particularly threatening. However, this study was limited in that survey data was obtained at two time points with a large number of participants not providing follow-up data, raising concerns regarding generalizability of results. Nonetheless, this study was significant in that it was the first to examine the longitudinal relationship between, sleep quality, PTSD, and perceived threat during the COVID-19 pandemic.
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