Examining sleep and post traumatic stress disorder in military veterans.

Abstract

This thesis comprises of an empirical paper that utilises Network Analysis and a systematic review. The focus of these papers was sleep and PTSD in military veterans.

Systematic Review
Research supports that sleep disturbances are not only a symptom of posttraumatic stress disorder (PTSD) but that they can also be a risk factor. These issues are prevalent in military veterans. Interventions focused on addressing sleep issues have also affected co-morbid mental health presentations like PTSD. The search strategy identified ten randomized controlled trials examining the efficacy of sleep-specific cognitive-behavioural therapy (CBT) as an intervention for addressing sleep, depressive, and PTSD symptoms in military veteran populations. Analysis showed significant reductions in PTSD symptoms and depression and sleep disturbances in the sleep-focused CBT group. Results indicate that sleep-focused CBT-based interventions appear to be a potentially efficacious approach to treating depressive and PTSD symptoms in military veterans. Clinical implications and areas for future research are discussed.

Empirical Paper
Post-traumatic stress disorder (PTSD) symptoms and disturbances in sleep are highly prevalent in military veteran populations. Research has highlighted the complex relationship between these two constructs. The current study investigates the relationship between sleep dysfunction and PTSD, using network analysis to look at these on a symptom level. Data was collected from 601 veterans living in Northern Ireland, and a network comprised of PTSD symptoms from the PTSD Checklist for DSM-5 (PCL-5) and items from the Pittsburgh Sleep Quality Index (PSQI) was constructed. The PSQI symptoms “sleep disturbances” and “sleep latency” demonstrated the highest bridge centrality values and thus the strongest connections to the PTSD items. For the PTSD items “concentration difficulties” and “flashbacks” were the strongest bridge connections to sleep items. These findings suggest that specific symptoms may play a role in the interactive relationship between sleep and PTSD symptoms. Identifying these symptoms can aid in the development of effective interventions for individuals who present with PTSD symptoms and sleep dysfunction.

Thesis is embargoed until 31 December 2025.

Date of Award	Dec 2022
Original language	English
Awarding Institution	Queen's University Belfast
Supervisor	Cherie Armour (Supervisor) & Donncha Hanna (Supervisor)