Abstract Details

Sleep is increasingly recognized as a marker of overall psychological health and resilience. Sleep complaints are also a hallmark of PTSD. Additionally, sleep disorders may be implicated in the underlying pathophysiology of PTSD and not just a consequence of the disease.

To compare objective and subjective sleep variables in Active Duty Service Members (ADSMs) with and without post-traumatic stress disorder (PTSD).

This is a case-controlled observational cohort from the Sleep Disorders Center of an academic military medical center. Sleep-related questionnaires (Epworth Sleepiness Scale, Insomnia Severity Index, Pittsburgh Sleep Quality Index) and polysomnographic (PSG) data were obtained.

One hundred sixty nine ADSMs underwent sleep evaluations. Of these, 43 had PTSD compared to 126 without PTSD. In patients with PTSD vs no PTSD, there was no significant difference in the rate of obstructive sleep apnea (60.47% vs 65.88% p=0.52) or mean apnea-hypopnea index (10.86/hr vs 14.32/hr, p=0.17). There was also no significant difference in patients with PTSD vs no PTSD for mean total sleep time (341.15 minutes vs 349.16 minutes, p=0.599), sleep efficiency (83% vs 84%, p=0.73), rapid eye movement (REM) sleep percentage (18% vs 17%, p=0.84), or any other objective sleep variable on PSG that was analyzed. Subjective sleepiness was similar between those with PTSD and no PTSD (ESS 12.88 vs 11.88 p=0.35). However, subjective insomnia symptoms and perceived sleep quality were worse in those with PTSD vs no PTSD (ISI 20.36 vs 15.18 p=<0.0001; PSQI 15.43 vs 11.05 p=<0.0001).

In a relatively young ADSM cohort, we found that patients with PTSD had more subjective complaints about sleep compared to those without PTSD but objective sleep parameters on PSG did not statistically differ between these two groups. This suggests a sleep-state misperception in patients with PTSD that is present at a relatively young age.