Open AccessDiurnal Rhythm Robustness in Individuals With PTSD and Insomnia and The Association With Sleep
Author(s) -
Luis Mascaro,
Andrew J. K. Phillips,
Jacob Clark,
Laura D. Straus,
Sean P.A. Drummond
Publication year - 2021
Publication title -
journal of biological rhythms
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.484
H-Index - 101
eISSN - 1552-4531
pISSN - 0748-7304
DOI - 10.1177/0748730420984563
Subject(s) - insomnia , actigraphy , circadian rhythm , psychology , population , rhythm , primary insomnia , sleep onset , diurnal temperature variation , sleep disorder , medicine , psychiatry , neuroscience , environmental health , atmospheric sciences , geology
Posttraumatic stress disorder (PTSD) and insomnia are characterized by sleep disturbances and daytime functional impairments. Actigraphy metrics can quantify diurnal rhythms via interdaily stability, intradaily variability, relative amplitude, and sleep regularity. Here, we (a) compared diurnal rhythms in PTSD, insomnia, and healthy control samples using linear mixed modeling; (b) compared inter-individual variability of diurnal rhythms between groups using variance ratio tests; and (c) examined correlations between diurnal rhythms and sleep measures within the clinical samples. Participants ( N = 98) wore wrist-activity monitors for one week and completed the Insomnia Severity Index and Pittsburgh Sleep Quality Index. Both clinical samples displayed significantly lower interdaily stability, relative amplitude, and sleep regularity compared with controls. Individuals with PTSD and insomnia did not differ on mean diurnal rhythm metrics. Both clinical samples showed more inter-individual variability in relative amplitude compared with controls, and the individuals with PTSD were distinguished from those with insomnia by greater inter-individual variability in interdaily stability and relative amplitude. Relative amplitude in the clinical samples was positively correlated with objective sleep efficiency and total sleep time. This is the first study to compare individuals with PTSD and insomnia on measures of diurnal rhythms, revealing those with PTSD and insomnia to have less robust and more variable diurnal rhythms compared with controls. Individuals with PTSD differed from those with insomnia in inter-individual variability of diurnal rest-activity stability and amplitude, highlighting this population as particularly heterogenous. Diurnal rhythm robustness might be considered an intervention target in insomnia and PTSD populations.