The PSQI demonstrated moderate convergent validity compared to measures of insomnia and fatigue and good divergent validity with measures of daytime sleepiness, circadian phase preference, and alcohol and marijuana use. The PSQI demonstrated considerable overlap with depression, anxiety, and perceived stress. Therefore, caution should be used with interpretation.

Sleep disturbances are common in posttraumatic stress disorder (PTSD) and can have major impacts on workplace performance and functioning. Although effects between PTSD and sleep broadly have been documented, little work has tested their day-to-day temporal relationship particularly in those exposed to occupational trauma. The present study examined daily, bidirectional associations between PTSD symptoms and self-reported sleep duration and quality in World Trade Center (WTC) responders oversampled for PTSD. WTC responders (N = 202; 19.3% with current PTSD diagnosis) were recruited from the Long Island site of the WTC health program. Participants were administered the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM–IV; SCID; First, Spitzer, Gibbon, & Williams, 1997) and completed daily assessments of PTSD symptoms, sleep duration and sleep quality for 7 days. PTSD symptoms on a given day were prospectively associated with shorter sleep duration (β = −.13) and worse sleep quality (β = −.18) later that night. Reverse effects were also significant but smaller, with reduced sleep duration (not quality) predicting increased PTSD the next day (β = −.04). Effects of PTSD on sleep duration and quality were driven by numbing symptoms, whereas effects of sleep duration on PTSD were largely based on intrusion symptoms. PTSD symptoms and sleep have bidirectional associations that occur on a daily basis, representing potential targets to disrupt maintenance of each. Improving PTSD numbing symptoms may improve sleep, and increasing sleep duration may improve intrusion symptoms in individuals with exposure to work-related traumatic events.

Objective: Epidemiologic data increasingly supports sleep as a determinant of cardiovascular disease risk. Fewer studies have investigated the mechanisms underlying this relationship using objective sleep assessment approaches. Therefore, the aim of this study was to examine associations between daily blood pressure and both objectively assessed sleep duration and efficiency.Methods: A diverse community sample of 300 men and women ages 21-70, enrolled in the North Texas Heart Study, participated in the study. Actigraphy assessed sleep was monitored over 2 consecutive nights with ambulatory blood pressure sampled randomly within 45-min blocks on the first and second day as well as the second night.Results: Overall, sleep duration results paralleled those of sleep efficiency. Individuals with lower sleep efficiency had higher daytime systolic (B=−0.35, SE=0.11, p=.0018, R 2 =0.26) but not diastolic BP (B=−0.043, SE=0.068, p=.52, R 2 =0.17) and higher nighttime BP (systolic: B=−0.37, SE=0.10, p<.001, R 2 =.15; diastolic: B=−0.20, SE=0.059, p<.001, R 2 =.14). Moreover, lower sleep efficiency on one night was associated with higher systolic (B=−0.51, SE=0.11, p<.001, R 2 =0.23) and diastolic BP (B=−0.17, SE=0.065, p=.012, R 2 =.16) the following day. When both sleep duration and efficiency were assessed together, sleep efficiency was associated with daytime systolic BP, while sleep duration was associated with nighttime BP.Conclusions: Lower sleep duration and efficiency are associated with higher daytime systolic BP and higher nighttime BP when assessed separately. When assessed together, sleep duration and