Self-Assessed Sleep Quality Partially Mediates the Relationship Between PTSD Symptoms and Functioning and Quality of Life in US Veterans: Results From the National Health and Resilience in Veterans Study

摘要

Objective: Sleep difficulties are among the most common symptoms reported by trauma survivors with posttraumatic stress disorder (PTSD). Problems with sleep have been associated with a wide range of physical, mental, cognitive difficulties, as well as reduced quality of life (QOL). The purpose of this study was to evaluate whether self-assessed sleep quality mediated the relationship between PTSD symptoms and functioning and QOL, in a nationally representative sample of U.S. military veterans. Method: Data were analyzed from a population-based sample of 3,157 U.S. military veterans who participated in the National Health and Resilience in Veterans Study (NIIRVS). Path analyses were conducted to assess whether sleep quality mediated the relationship between PTSD symptoms and measures of functioning and QOL. Results: A total of 714 veterans (weighted 27.6%) reported poor sleep quality. The prevalence of poor sleep quality was significantly higher among veterans who screened positive for probable PTSD compared with those who did not (84.2% vs. 24.7%). Path analyses revealed significant associations between greater severity of PTSD symptoms and sleep quality, beta = 0.42. as well as significant associations between greater severity of PTSD symptoms and scores on measures of cognitive functioning, beta = -0.54, mental health functioning, beta = -0.57, physical functioning, beta = -0.19, and overall QOL, beta = -0.40. Poorer sleep quality partially mediated these associations, with the strongest effects observed for physical functioning, beta = -0.28, and QOL, beta = -0.27. Conclusions: Results of this study extend prior research on the relationship between PTSD symptoms, sleep, and functioning and QOL in a nationally representative sample of U.S. veterans.