Predictors of insomnia symptoms and nightmares among individuals with post‐traumatic stress disorder: an ecological momentary assessment study
Despite the high levels of comorbidity between post‐traumatic stress disorder (PTSD) and sleep disturbance, little research has examined the predictors of insomnia and nightmares in this population. The current study tested both PTSD‐specific (i.e. PTSD symptoms, comorbid anxiety and depression, nightmares and fear of sleep) and insomnia‐specific (i.e. dysfunctional beliefs about sleep, insomnia‐related safety behaviours and daily stressors) predictors of sleep quality, efficiency and nightmares in a sample of 30 individuals with PTSD. Participants participated in ecological momentary assessment to determine how daily changes in PTSD‐ and insomnia‐related factors lead to changes in sleep. Multi‐level modelling analyses indicated that, after accounting for baseline PTSD symptom severity, PTSD‐specific factors were associated with insomnia symptoms, but insomnia‐specific factors were not. Only daytime PTSD symptoms and fear of sleep predicted nightmares. Both sleep‐ and PTSD‐related factors play a role in maintaining insomnia among those with PTSD, while nightmares seem to be linked more closely with only PTSD‐related factors.
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