Correlates of daytime sleepiness in patients with posttraumatic stress disorder and sleep disturbance.
OBJECTIVE
To assess the correlates of daytime sleepiness in patients with a lifetime diagnosis of posttraumatic stress disorder (PTSD) and ongoing sleep disturbance not due to sleep apnea or other diagnosed sleep disorders.


METHODS
The sample consisted of 26 veterans receiving mental health care at the Minneapolis VA Medical Center, Minneapolis, Minnesota. The Epworth Sleepiness Scale was the primary outcome measure. Other sleep-related instruments consisted of the Pittsburgh Sleep Quality Scale, a daily sleep log, and daily sleep actigraphy. In addition, data included 3 symptom ratings (Posttraumatic Stress Disorder Checklist, Clinician Administered PTSD Scale [CAPS], and Beck Depression Inventory). Data were collected from 2003 to 2005. Current and lifetime PTSD diagnoses were based on DSM-IV criteria and were obtained by experienced psychiatrists using the CAPS interview.


RESULTS
Univariate analyses showed that daytime sleepiness on the Epworth Sleepiness Scale was associated with daytime dysfunction on the Pittsburgh Sleep Quality Index (P < .001), less use of sleeping medication (P = .02), and more self-rated posttraumatic symptoms (P = .05). Within posttraumatic symptom categories, hypervigilance symptoms were more correlated with daytime sleepiness (P = .03) than were reexperiencing and avoidance symptoms (P = .09 for both).


CONCLUSIONS
In this selected sample, daytime sleepiness was most strongly and independently associated with daytime dysfunction.
Westermeyer
Joseph
J
Mental Health Service, Minneapolis VA Medical Center, Minneapolis, Minnesota ; Department of Psychiatry, University of Minnesota, Minneapolis ; and Department of Psychology, University of Texas, Houston.
Khawaja
Imran
I
Freerks
Melesa
M
Sutherland
R John
RJ
Engle
Kay
K
Johnson
David
D
Thuras
Paul
P
Rossom
Rebecca
R
Hurwitz
Thomas
T