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Sleep Quality Disturbances Are Associated with White Matter Alterations in Veterans with Post-Traumatic Stress

Philine Rojczyk1,2, Johanna Seitz-Holland1,3, Elisabeth Kaufmann1,2,4

  • 1Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02145, USA.

Journal of Clinical Medicine
|March 11, 2023
PubMed

Insights

Poor sleep quality significantly impacts brain health in veterans with PTSD and mTBI. Sleep disturbances fully mediate the link between PTSD symptoms and white matter damage, emphasizing the need for sleep interventions.

Area of Science:

  • Neuroscience
  • Sleep Medicine
  • Traumatic Brain Injury Research

Background:

  • Sleep disturbances are common in mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD).
  • Alterations in white matter (WM) microstructure are observed in mTBI and PTSD, but the role of sleep quality is unclear.

Purpose of the Study:

  • To investigate the compounding effect of poor sleep quality on white matter (WM) microstructure in veterans with mTBI and/or PTSD.
  • To assess the relationship between PTSD symptom severity, sleep quality, and WM integrity.

Main Methods:

  • Diffusion magnetic resonance imaging (dMRI) and Pittsburgh Sleep Quality Index (PSQI) data from 180 male veterans were analyzed.
  • Participants were categorized into PTSD, mTBI, comorbid PTSD+mTBI, and control groups.
  • ANCOVAs, regression, and mediation models were used to examine associations.

Main Results:

  • Veterans with PTSD and comorbid PTSD+mTBI reported significantly poorer sleep quality than other groups.
  • Poor sleep quality was associated with abnormal WM microstructure in the comorbid PTSD+mTBI group.
  • Poor sleep quality fully mediated the relationship between PTSD symptom severity and impaired WM microstructure.

Conclusions:

  • Sleep disturbances significantly impact brain health, particularly white matter integrity, in veterans with comorbid PTSD and mTBI.
  • Targeted sleep interventions are crucial for mitigating neurological consequences in this population.
Keywords:
PSQIPTSDdMRImTBImilitarysleep disturbances

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