Physical health status and sleep quality in veterans with PTSD

Post-traumatic stress disorder (PTSD) has a wide range of effects on physical and mental health. PTSD puts patients at higher risk for poor physical health. It often results in greater medical utilization, poor self-reported health, high rates of chronic illness, negative health behaviors, and higher rates of morbidity and mortality. In trauma-exposed male veterans with and without chronic PTSD (n=35) at a Veterans Affairs medical center, poor self-rated physical and mental health was significantly correlated with clinician-assessed PTSD diagnosis (r=-.389; -.471 p<0.01), as well as with self-reported PTSD symptom severity (r=-.544; -.642, p<0.01). Sleep disturbance is a commonly reported symptom in PTSD, and poor self-reported sleep quality was significantly related to self-reports of poor physical health (r=-.522, p<0.01). Poor sleep quality was also correlated with increased psychological tension, self-reported PTSD symptom severity, and fatigue and anergia (r=.539; .569; .581, p<0.01).Actigraphy is an objective measure of sleep. Preliminary actigraphic results of 30 veterans with PTSD and 14 no-PTSD controls indicated that veterans with PTSD had significantly longer sleep onset latency, less total sleep time, poorer sleep efficiency, and more wake after sleep onset. Understanding the interrelationships between PTSD, sleep, and overall quality of life should be a focus for both physical and behavioral health clinicians, since poor sleep may exacerbate mental and physical symptoms. Interventions that target sleep disturbances, such as sleep hygiene education, may be an important preventative measure to reduce symptoms of mental distress and to improve overall health and wellness.