Department of Psychology, University of California, 2121 Berkeley Way, Berkeley, CA, 94720, USA.
Dissemination and Training Division, National Center for PTSD, 795 Willow Road, Menlo Park, CA, 94025, USA.
BMC Psychiatry. 2023 Nov 22;23(1):869. doi: 10.1186/s12888-023-05373-9.
Regularizing bedtime and out-of-bed times is a core component of behavioral treatments for sleep disturbances common among patients with posttraumatic stress disorder (PTSD). Although improvements in subjective sleep complaints often accompany improvements in PTSD symptoms, the underlying mechanism for this relationship remains unclear. Given that night-to-night sleep variability is a predictor of physical and mental well-being, the present study sought to evaluate the effects of bedtime and out-of-bed time variability on daytime affect and explore the optimal window lengths of over which variability is calculated.
For about 30 days, male U.S. military veterans with PTSD (N = 64) in a residential treatment program provided ecological momentary assessment data on their affect and slept on beds equipped with mattress actigraphy. We computed bedtime and out-of-bed time variability indices with varying windows of days. We then constructed multilevel models to account for the nested structure of our data and evaluate the impact of bedtime and out-of-bed time variability on daytime affect.
More regular bedtime across 6-9 days was associated with greater subsequent positive affect. No similar effects were observed between out-of-bed time variability and affect.
Multiple facets of sleep have been shown to differently predict daily affect, and bedtime regularity might represent one of such indices associated with positive, but not negative, affect. A better understanding of such differential effects of facets of sleep on affect will help further elucidate the complex and intertwined relationship between sleep and psychopathology.
The trial retrospectively was registered on the Defense Technical Information Center website: Award # W81XWH-15-2-0005.
对于创伤后应激障碍（PTSD）患者常见的睡眠障碍，规律的就寝和起床时间是行为治疗的核心组成部分。尽管主观睡眠问题的改善通常伴随着 PTSD 症状的改善，但这种关系的潜在机制仍不清楚。鉴于夜间睡眠变异性是身心健康的预测指标，本研究旨在评估就寝和起床时间变异性对白天情绪的影响，并探讨计算变异性的最佳窗口长度。
在大约 30 天的时间里，居住在治疗计划中的患有 PTSD 的美国男退伍军人（N=64）提供了关于他们情绪的生态瞬间评估数据，并在配备床垫活动记录仪的床上睡觉。我们使用不同天数的窗口计算了就寝和起床时间变异性指数。然后，我们构建了多层次模型来解释数据的嵌套结构，并评估了就寝和起床时间变异性对白天情绪的影响。
6-9 天内更规律的就寝时间与随后更大的积极情绪有关。在起床时间变异性和情绪之间没有观察到类似的效果。
睡眠的多个方面已被证明以不同的方式预测日常情绪，而就寝时间的规律性可能代表与积极情绪相关的一个指数，而不是消极情绪。更好地理解睡眠各个方面对情绪的这种差异影响将有助于进一步阐明睡眠和精神病理学之间复杂且相互交织的关系。
该试验是在国防技术信息中心网站上进行的回顾性注册：奖项号 W81XWH-15-2-0005。
