title: The mediating effects of sleep in the relationship between traumatic stress and health symptoms in urban police officers.
abstract: OBJECTIVE
  Posttraumatic stress symptoms have been associated with increased health problems across numerous studies. Sleep disruption, one of the principal symptoms resulting from traumatic stress, has also been shown to produce health problems. This study explored the hypothesis that the relationship between posttraumatic stress symptoms and health is mediated by sleep problems.
  
  
  METHODS
  A sample of 741 police officers were administered measures of traumatic stress symptoms, sleep, health functioning, and somatic symptoms.
  
  
  RESULTS
  Traumatic stress symptoms were significantly related to both somatic symptoms (R2 = 0.18, p <.001) and health functioning (R2 = 0.02, p <.01). The relationship between somatic symptoms and traumatic stress symptoms was partially mediated by sleep (p <.001). The relationship between traumatic stress symptoms and health functioning was fully mediated by sleep.
  
  
  CONCLUSIONS
  Although design characteristics, such as cross-sectional sampling, limit the inferences that can be drawn, these findings suggest that sleep may serve as an important mediator between traumatic stress and somatic symptoms.
authors.affiliation: University of California, San Francisco, California, USA. dmohr@itsa.ucsf.edu
authors.forename: David
authors.initials: D
authors.lastname: Mohr
authors.forename: Kumar
authors.initials: K
authors.lastname: Vedantham
authors.forename: Thomas
authors.initials: T
authors.lastname: Neylan
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Metzler
authors.forename: Suzanne
authors.initials: S
authors.lastname: Best
authors.forename: Charles R
authors.initials: CR
authors.lastname: Marmar
mesh_terms: D001290:Attitude; D001416:Back Pain / Q000209:etiology / Q000523:psychology; D002637:Chest Pain / Q000209:etiology / Q000523:psychology; D004244:Dizziness / Q000209:etiology* / Q000523:psychology; D005260:Female; D006261:Headache / Q000209:etiology / Q000523:psychology; D006304:Health Status; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology* / Q000523:psychology; D010292:Paresthesia / Q000209:etiology* / Q000523:psychology; D016495:Police; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D014754:Violence