Department of Psychiatry, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, Republic of Korea.
Department of Psychiatry, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, 07985, Republic of Korea.
Sleep Med. 2021 Jun;82:110-116. doi: 10.1016/j.sleep.2021.03.042. Epub 2021 Apr 9.
This study investigated the association between changes in sleep duration after disaster and post-traumatic stress disorder (PTSD) symptoms and the mediating role of resilience on the association.
Data were collected from 2951 Korean adults who were victims of a natural disaster and did not have any mental or medical illnesses before the event. They completed a long-term survey on changes in life for disaster victims using computer-aided personal interviews. Changes in sleep duration before and one month after experiencing a disaster were assessed using a self-reported questionnaire. Resilience levels and PTSD symptoms were measured using the Brief Resilience Scale and the Impact of Event Scale - Revised, respectively, and more than 33 of the IES-R score items were defined as significant PTSD symptoms. Multivariate logistic regression was used to examine the associations between changes in sleep duration and PTSD symptoms. Additionally, mediating studies were conducted to identify the role of resilience on the association.
Compared with participants without significant PTSD symptoms, those with PTSD symptoms were more likely to be older and female (group without significant PTSD symptom: mean age = 56.12 ± 18.70 years, female sex = 49.24%; group with significant PTSD symptoms: mean age = 60.88 ± 15.66 years, female sex = 59.52%). Compared with disaster victims without changes in sleep duration, those who had shorter sleep duration after disaster had a higher risk of significant PTSD symptoms (OR = 2.89, 95% Cl = 2.31-3.62, p < 0.001). In the mediating study, resilience level significantly mediated the relationship between reduced sleep duration and PTSD symptoms (direct effect: β = 0.208, 95% Cl = 0.166-0.250, p < 0.001; indirect effect: β = 0.007, 95% Cl = 0.002-0.011, p < 0.001; total effect: β = 0.215, 95% Cl = 0.173-0.257, p < 0.001).
This study revealed that individuals with reduced sleep duration after disaster had a higher risk of PTSD symptoms, while those with increased sleep duration did not. In addition, mediating effects of resilience level on the relationship between reduced sleep duration and significant PTSD symptoms were observed.
本研究旨在探讨灾难后睡眠时长变化与创伤后应激障碍（PTSD）症状之间的关联，以及韧性在其中的中介作用。
本研究的数据来自 2951 名韩国成年人，他们在事件发生前曾遭受自然灾害，且没有任何精神或医学疾病。使用计算机辅助个人访谈，对他们进行了一项关于灾难受害者生活变化的长期调查。使用自我报告问卷评估灾难前后睡眠时长的变化。使用简要韧性量表和事件影响量表修订版分别测量韧性水平和 PTSD 症状，超过 IES-R 量表 33 个项目的得分被定义为显著 PTSD 症状。采用多变量逻辑回归分析睡眠时长变化与 PTSD 症状之间的关联。此外，还进行了中介研究，以确定韧性在这种关联中的作用。
与无显著 PTSD 症状的参与者相比，有 PTSD 症状的参与者更可能年龄较大且为女性（无显著 PTSD 症状组：平均年龄 56.12 ± 18.70 岁，女性比例为 49.24%；有显著 PTSD 症状组：平均年龄 60.88 ± 15.66 岁，女性比例为 59.52%）。与睡眠时长无变化的灾难受害者相比，灾难后睡眠时长较短的患者发生显著 PTSD 症状的风险更高（OR=2.89，95%Cl=2.31-3.62，p<0.001）。在中介研究中，韧性水平显著中介了睡眠时长减少与 PTSD 症状之间的关系（直接效应：β=0.208，95%Cl=0.166-0.250，p<0.001；间接效应：β=0.007，95%Cl=0.002-0.011，p<0.001；总效应：β=0.215，95%Cl=0.173-0.257，p<0.001）。
本研究表明，灾难后睡眠时长减少的个体发生 PTSD 症状的风险较高，而睡眠时长增加的个体则没有。此外，还观察到韧性水平对睡眠时长减少与显著 PTSD 症状之间关系的中介作用。
