Associations between post-traumatic stress symptoms and sleep/circadian parameters: Exploring the effect of chronotype as a moderator variable

ABSTRACT

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 (n = 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.

KEYWORDS:

• Chronotype
• post-traumatic stress symptoms
• sleep quality
• actigraphy
• rest-activity rhythms
• intradaily variability
• interdaily stability

Acknowledgments

The authors thank the participants and their relatives for their generous contribution in this research.

Disclosure statement

U.F. is co-founder and president of sleepActa S.r.l, a spin-off company of the University of Pisa operating in the field of sleep medicine. No potential conflict of interest was reported by all other author(s).

Data availability statement

Data not available due to ethical restrictions.  

Additional information

Funding

This work has been partially supported by Italian Ministry of Health under grant-RC 1.21 “Monitoraggio e tele-monitoraggio del sonno in età evolutiva e in pazienti adulti” and the 5 × 1000 voluntary contributions; Fondazione Arpa Onlus, a non-profit organization (https://fondazionearpa.it).