PTSD-related paradoxical insomnia: an actigraphic study among veterans with chronic PTSD

Background: Sleep disturbance is a common self-reported complaint by PTSD patients. However, there are controversies in documenting objective indices of disrupted sleep in these patients. The aim of the present study was to assess sleep disturbances in veterans with chronic PTSD, using both subjective and objective assessments. Methods: Thirty two PTSD patients with complaints of insomnia were evaluated using the Clinician Administrated PTSD Scale version 1 (CAPS) and completed the Pittsburg Sleep Quality Index (PSQI) for subjective evaluation of their sleep. For objective evaluation, participants underwent two consecutive overnight actigraphic assessments. Total Sleep Time (TST), Sleep Latency (SL), Sleep Efficiency (SE) and Number of Awakening (NWAK) were measured in all participants. Results: Participants underestimated TST (p less than 0.0001), SE (p less than 0.0001) as well as NASO (0.03) in the questionnaire compared to the actigraphic assessment and overestimated SL (p less than 0.0001). Conclusions: Objective sleep parameters do not adversely affect veterans with chronic PTSD. Self-reported sleep disturbance in these patients is not reliable and objective sleep assessments are necessary.