Department of Translational Research and New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.
Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy.
Chronobiol Int. 2023 May;40(5):581-595. doi: 10.1080/07420528.2023.2189952. Epub 2023 Apr 12.
The present study aimed at evaluating how post-traumatic stress symptoms (PTSS) are associated with rest-activity circadian and sleep-related parameters, assessed both subjectively (via questionnaires) and objectively (via actigraphy). Specifically, we explored whether chronotype could moderate the association between sleep/circadian parameters and PTSS. Participants ( = 120 adults; mean age 35.6 ± 14; 48 male) were assessed through the Trauma and Loss Spectrum Self Report (TALS-SR) for lifetime PTSS, the reduced version of the Morningness-Eveningness Questionnaire (rMEQ) for chronotype, the Pittsburgh Sleep Quality Index (PSQI) for self-reported sleep quality, and wrist actigraphy for sleep and circadian parameters. Eveningness, poor self-reported sleep quality, lower sleep efficiency (SE), lower interdaily stability (IS), and higher intradaily variability (IV) were correlated with higher TALS-SR scores. Regression analyses showed that IV, SE, and PSQI remained associated with TALS symptomatic domains after adjusting for potentially confounding factors (age and gender). Moderation analysis showed that only the PSQI remained significantly associated with TALS symptomatic domains; however, the interaction with chronotype was not significant. Targeting self-reported sleep disturbances and rest-activity rhythms fragmentation could mitigate PTSS. Although the effect of chronotype as a moderator of the associations between sleep/circadian parameters and PTSS was not significant, eveningness was associated with higher TALS scores, thus confirming the vulnerability of evening types to worse stress reactions.
本研究旨在评估创伤后应激症状（PTSS）与昼夜节律和睡眠相关参数之间的关系，这些参数既可以通过问卷进行主观评估，也可以通过活动记录仪进行客观评估。具体来说，我们探讨了时型是否可以调节睡眠/昼夜节律参数与 PTSS 之间的关联。研究对象为 120 名成年人（平均年龄 35.6±14 岁，48 名男性），通过创伤和丧失频谱自我报告（TALS-SR）评估终生 PTSS，使用简化版 Morningness-Eveningness Questionnaire（rMEQ）评估时型，使用匹兹堡睡眠质量指数（PSQI）评估自我报告的睡眠质量，使用腕部活动记录仪评估睡眠和昼夜节律参数。研究结果显示，晚型、自我报告的睡眠质量差、睡眠效率低（SE）、日间稳定性差（IS）和日内变异性高（IV）与 TALS-SR 评分较高相关。回归分析显示，在调整潜在混杂因素（年龄和性别）后，IV、SE 和 PSQI 仍与 TALS 症状领域相关。调节分析显示，只有 PSQI 与 TALS 症状领域仍显著相关；然而，时型与 PSQI 的交互作用不显著。针对自我报告的睡眠障碍和昼夜节律紊乱进行干预，可能会减轻 PTSS。虽然时型作为睡眠/昼夜节律参数与 PTSS 之间关联的调节因素的作用不显著，但晚型与较高的 TALS 评分相关，这证实了晚型更容易出现更严重的应激反应。
