title: Sleep disturbances predict later trauma-related distress: cross-panel investigation amidst violent turmoil.
abstract: OBJECTIVE
  Sleep disturbances, including trouble falling and remaining asleep and recurrent nightmares, are symptoms of posttraumatic stress. A growing body of literature indicates that sleep disturbance may also convey vulnerability for the continuation of other symptoms of posttraumatic stress, including fear, anxiety, and heightened arousal. However, longitudinal research, which could help understand how these relationships unfold over time, has been limited.
  
  
  METHODS
  The longitudinal relationships between sleep disturbance and posttraumatic stress were investigated in 779 Palestinian adults randomly selected and interviewed twice during the period from April 2008 to November 2008, amid ongoing violent political turmoil. The recruitment method produced a representative sample and excellent retention. Cross-panel structural equation modeling was used to examine relationships between sleep and distress across two study periods.
  
  
  RESULTS
  Results indicated that initial sleep problems were associated with increased posttraumatic stress disorder (PTSD), depression, and intrapersonal resource loss at follow-up 6 months later, but initial PTSD, depression, and intrapersonal resource loss were not associated with increased sleep problems at follow-up.
  
  
  CONCLUSIONS
  Sleep problems may confer vulnerability to longer-term distress in the presence of ongoing political violence. Future research should examine whether interventions targeting trauma-related sleep problems may improve prevention and treatment for PTSD and related disorders.
authors.affiliation: Traumatic Stress Center, Department of Behavioral Sciences, Rush University Medical Center.
authors.forename: James I
authors.initials: JI
authors.lastname: Gerhart
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Hall
authors.affiliation: Department of Psychiatry, University of Louisville.
authors.forename: Eric U
authors.initials: EU
authors.lastname: Russ
authors.affiliation: School of Political Science, University of Haifa.
authors.forename: Daphna
authors.initials: D
authors.lastname: Canetti
authors.affiliation: Traumatic Stress Center, Department of Behavioral Sciences, Rush University Medical Center.
authors.forename: Stevan E
authors.initials: SE
authors.lastname: Hobfoll
mesh_terms: D000328:Adult; D018912:Arabs / Q000523:psychology* / Q000706:statistics & numerical data; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011057:Politics; D036301:Qualitative Research; D012893:Sleep Wake Disorders / Q000523:psychology*; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D014754:Violence / Q000523:psychology