W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA; Wake Forest School of Medicine, Winston-Salem, NC, USA.
W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA.
J Affect Disord. 2021 Mar 1;282:236-241. doi: 10.1016/j.jad.2020.12.161. Epub 2020 Dec 30.
Though sleep disturbance has shown to negatively affect outcomes related to post-deployment conditions, it is unclear whether and how sleep disturbance affects mental health symptoms beyond these conditions. We evaluated the independent and moderating effects of sleep quality on posttraumatic stress disorder (PTSD), depressive, and neurobehavioral symptoms beyond mild traumatic brain injury (TBI) and PTSD diagnosis.
Participants were 274 US combat veterans who deployed after 9/11. All completed diagnostic TBI and PTSD interviews and self-report measures of sleep quality, as well as PTSD, depressive, and neurobehavioral symptoms. Only those who passed symptom validity were included in analyses. Hierarchical regression evaluated the contribution of sleep quality to outcomes beyond PTSD and mild TBI. Moderation analyses evaluated interactions between mild TBI, PTSD, and sleep quality on symptom outcomes.
Mild TBI was only significantly associated with PTSD (p = .006) and neurobehavioral (p = .003) symptoms. PTSD diagnosis was associated with PTSD (p < .001), depressive (p < .001), and neurobehavioral symptoms (p < .001) beyond mild TBI. Sleep quality explained additional significant variance in all three outcome measures (p < .001), and also significantly moderated the effects of PTSD diagnosis on neurobehavioral symptoms (ΔR = .01, p = .023).
Sleep was evaluated subjectively and therefore must be interpreted in this context.
These results provide support that sleep quality is an independent contributing factor to health outcomes in post-deployment veterans and should be considered in etiology of complaints.
尽管睡眠障碍已被证明会对与部署后状况相关的结果产生负面影响，但目前尚不清楚睡眠障碍是否以及如何在这些状况之外影响心理健康症状。我们评估了睡眠质量对创伤后应激障碍（PTSD）、抑郁和神经行为症状的独立和调节作用，这些症状超出了轻度创伤性脑损伤（TBI）和 PTSD 诊断的范围。
参与者是 274 名在 9/11 后部署的美国作战老兵。所有人都完成了创伤性脑损伤和 PTSD 访谈以及睡眠质量的自我报告测量，以及 PTSD、抑郁和神经行为症状。只有通过症状有效性测试的人才被纳入分析。层次回归评估了睡眠质量对 PTSD 和轻度 TBI 以外结果的贡献。调节分析评估了轻度 TBI、PTSD 和睡眠质量对症状结果的相互作用。
轻度 TBI 仅与 PTSD（p=.006）和神经行为症状（p=.003）显著相关。PTSD 诊断与 PTSD（p<.001）、抑郁（p<.001）和神经行为症状（p<.001）显著相关，这些症状超出了轻度 TBI 的范围。睡眠质量在所有三个结果测量中解释了额外的显著差异（p<.001），并且还显著调节了 PTSD 诊断对神经行为症状的影响（ΔR=.01，p=.023）。
睡眠是主观评估的，因此必须在此背景下进行解释。
这些结果为睡眠质量是部署后退伍军人健康结果的一个独立影响因素提供了支持，应在病因学方面考虑到这些结果。
