Edda Bjork Thordardottir1, Ingunn Hansdottir2, Unnur Anna Valdimarsdottir1,3,4, Jillian C Shipherd5,6, Heidi Resnick7, Berglind Gudmundsdottir8,9. 1. Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 2. Faculty of Psychology, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 3. Department of Epidemiology, Harvard School of Public Health, Boston, MA. 4. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden. 5. National Center for PTSD, VA Boston Healthcare System, Boston, MA. 6. Department of Psychiatry, Boston University School of Medicine, Boston, MA. 7. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC. 8. Mental Health Services, The National University Hospital of Iceland, Reykjavik, Iceland. 9. Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
Abstract
STUDY OBJECTIVES: Limited data exist on the association between trauma and sleep across developmental stages, particularly trauma experienced in childhood and sleep in adulthood. We assessed sleep quality across the developmental spectrum among avalanche survivors 16 years after exposure as compared to a matched comparison cohort. METHODS: Participants were survivors of two avalanche-affected towns (n = 286) and inhabitants of non-exposed towns (n = 357). Symptoms were assessed with respect to the survivors' developmental stage at the time of the disaster: childhood (2-12), adolescence (13-19), young adult (20-39), and adult (≥ 40). The Posttraumatic Diagnostic Scale, Pittsburgh Sleep Quality Index and Pittsburgh Sleep Quality Index PTSD Addendum were used. RESULTS: Overall PTSD symptoms were not associated with avalanche exposure in any age groups under study. However, survivors who were children at the time of the disaster were 2.58 times (95% CI 1.33-5.01) more likely to have PTSD-related sleep disturbances (PSQI-A score ≥ 4) in adulthood than their non-exposed peers, especially symptoms of acting out dreams (aRR = 3.54; 95% CI 1.15-10.87). Those who were adults at time of the exposure had increased risk of trauma-related nightmares (aRR = 2.69; 95% CI 1.07-6.79 for young adults aRR = 3.07; 95% CI 1.51-6.24 for adults) compared to their non-exposed peers. CONCLUSIONS: Our data indicate a chronicity of PTSD-related sleep disturbances, particularly among childhood trauma survivors. REM sleep disturbances may have different manifestations depending on the developmental stage at the time of trauma exposure.
STUDY OBJECTIVES: Limited data exist on the association between trauma and sleep across developmental stages, particularly trauma experienced in childhood and sleep in adulthood. We assessed sleep quality across the developmental spectrum among avalanche survivors 16 years after exposure as compared to a matched comparison cohort. METHODS:Participants were survivors of two avalanche-affected towns (n = 286) and inhabitants of non-exposed towns (n = 357). Symptoms were assessed with respect to the survivors' developmental stage at the time of the disaster: childhood (2-12), adolescence (13-19), young adult (20-39), and adult (≥ 40). The Posttraumatic Diagnostic Scale, Pittsburgh Sleep Quality Index and Pittsburgh Sleep Quality Index PTSD Addendum were used. RESULTS: Overall PTSD symptoms were not associated with avalanche exposure in any age groups under study. However, survivors who were children at the time of the disaster were 2.58 times (95% CI 1.33-5.01) more likely to have PTSD-related sleep disturbances (PSQI-A score ≥ 4) in adulthood than their non-exposed peers, especially symptoms of acting out dreams (aRR = 3.54; 95% CI 1.15-10.87). Those who were adults at time of the exposure had increased risk of trauma-related nightmares (aRR = 2.69; 95% CI 1.07-6.79 for young adults aRR = 3.07; 95% CI 1.51-6.24 for adults) compared to their non-exposed peers. CONCLUSIONS: Our data indicate a chronicity of PTSD-related sleep disturbances, particularly among childhood trauma survivors. REM sleep disturbances may have different manifestations depending on the developmental stage at the time of trauma exposure.
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