Assessing sleep quality using self-report and actigraphy in PTSD

Area of Science:

• Psychiatry
• Sleep Medicine
• Neuroscience

Background:

• Sleep disturbances are frequently reported in post-traumatic stress disorder (PTSD).
• Objective evidence supporting subjective sleep complaints in PTSD is often lacking.
• Discrepancies between subjective and objective sleep assessments are common in clinical populations.

Purpose of the Study:

• To compare subjective (self-report) and objective (actigraphy) sleep evaluations in veterans with PTSD and controls.
• To investigate potential memory biases in the subjective reporting of sleep quality in PTSD.

Main Methods:

• Participants included veterans with and without PTSD.
• Sleep was assessed using the Pittsburgh Sleep Quality Index (retrospective) and a sleep diary (recording night).
• Objective sleep data were collected using wrist actigraphy (Actiwatch-64) on the recording night.

Main Results:

• The PTSD group reported significantly worse sleep quality retrospectively and on the recording night compared to controls.
• Objective actigraphy and diary measures on the recording night showed no significant differences in awakenings, total sleep time, or wake after sleep onset between groups.
• Diary-reported awakenings were fewer than actigraphically measured awakenings.

Conclusions:

• Subjective reports of poor sleep in PTSD may be influenced by memory bias, overestimating sleep disturbances.
• Objective sleep measures do not consistently support subjective complaints of poor sleep in veterans with PTSD.
• Further research is needed to understand the mechanisms underlying sleep perception in PTSD.