Sleep disturbance in post-traumatic stress disorder (PTSD): a systematic review and meta-analysis of actigraphy studies

Abstract

Background: Sleep disturbance has been described as a 'hallmark' symptom of posttraumatic stress disorder (PTSD). Although there are robust findings of self-reported sleep disturbance in PTSD, evidence of sleep disturbance measured using actigraphy is less certain. Objective: To conduct a systematic review and meta-analysis to determine whether there are any significant differences between individuals with and without PTSD in actigraphderived sleep measures. Method: Case-control studies comparing participants with current PTSD to those without PTSD were eligible for inclusion. Sleep parameters of interest were: (1) total sleep time; (2) sleep onset latency; (3) wake after sleep onset (WASO); and (4) sleep efficiency. Data were meta-analysed as standardised mean differences (SMDs) and potential sources of heterogeneity were explored through meta-regression. Six actigraphy studies with 405 participants were included. Results: There was no evidence of a statistically significant difference between those with and without PTSD in total sleep time (SMD 0.09, 95%CI −0.23 to 0.42); WASO (SMD 0.18, 95% CI −0.06 to 0.43); sleep latency (SMD 0.32, 95%CI −0.04 to 0.69); or sleep efficiency (SMD −0.28, 95%CI −0.78 to 0.21). Conclusions: Further high-quality research is required to determine whether there is a true difference in sleep between those with and without PTSD. Perturbación del sueño en el Trastorno de Estrés Postraumático (TEPT): una revisión sistemática y metaanálisis de estudios de actigrafía Antecedentes: La perturbación del sueño se ha descrito como un síntoma 'distintivo' del trastorno de estrés postraumático (TEPT). Aunque existen hallazgos sólidos de trastornos del sueño en el TEPT a través de auto-reportes, la evidencia de éstos medidos con el uso de actigrafía es más incierta. Objetivo: Realizar una revisión sistemática y un metanálisis para determinar si hay diferencias significativas entre los individuos con y sin TEPT en medidas de sueño derivadas de la actigrafía. Método: Los estudios de casos y controles incluidos como elegibles fueron aquéllos que compararon participantes con TEPT en curso con aquellos participantes sin TEPT. Los parámetros de sueño de interés fueron: (1) tiempo total del sueño; (2) latencia del inicio del sueño; (3) vigilia después del inicio de sueño (wake after sleep onset, WASO, en su sigla en inglés); y (4) eficiencia del sueño. Los datos fueron meta-analizados como diferencias de medias estandarizadas (DME) y se exploraron las posibles fuentes de heterogeneidad mediante metarregresión. Se incluyeron seis estudios de actigrafía con 405 participantes. Resultados: No hubo evidencia de una diferencia estadísticamente significativa entre aquellos con y sin TEPT en el tiempo total del sueño (DME 0.09, IC 95%: −0,23 a 0,42); WASO (DME 0.18, IC 95% −0.06 a 0.43); latencia del sueño (SMD 0.32, IC 95% −0.04 a 0.69); o eficiencia del sueño (SMD −0.28, IC 95% −0.78 a 0.21). Conclusiones: Se requieren futuras investigaciones de alta calidad para determinar si existe una verdadera diferencia ...

The influence of risk perception for COVID‐19 pandemic on posttraumatic stress disorder in healthcare workers: A survey from four designated hospitals

“…Sleep and leisure activity were indispensable daily behaviours for regulating psychological stress. A systematic review and meta‐analysis has confirmed sleep quality was impaired in individuals with higher PTSD symptoms (Lewis et al, 2020). The studies conducted in COVID‐19 pandemic also have reported sleep quality was negatively correlated with PTSD symptoms in general HCWs and residents from hardest‐hit area (Liu et al, 2020; Yin et al, 2020).…”

Sleep Quality and Eating Disorder-Related Psychopathologies in Patients with Night Eating Syndrome and Binge Eating Disorders

“…This strengthens the assumption that subjective sleep quality is associated with the level of psychopathology rather than objective sleep quality, and is in line with previous results on patients with ED [ 33 , 34 , 38 , 68 ]. The discrepancies between subjective complaints of sleep disorders and electroencephalogram (EEG) findings are commonly seen in studies on patients with post-traumatic stress disorder (PTSD) [ 71 , 72 ]. These may be related to the traumatic life events associated with ED in general [ 13 ] and ED with NES in particular [ 12 ].…”

Polysomnographic Sleep and Attentional Deficits in Traumatized North Korean Refugees

“…Furthermore, this finding is consistent with previous studies reporting an association between decreased sleep continuity and cognitive decline. 21,[53][54][55][56][57] The association between sleep and trauma-related symptoms has been widely studied, 58,59 and REM sleep and SWS have been found to play a role in altered cognitive performance in traumatized people. [59][60][61] Furthermore, a relationship has been established between reduced arousal during sleep and adaptive cognitive processing of traumatic experiences.…”