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Insecure attachment is an independent correlate of objective sleep disturbances in military veterans.

ABSTRACT: Sleep disturbances and interpersonal problems are highly prevalent in military veterans with post-traumatic stress disorder (PTSD) and are associated with substantial comorbidities and increased healthcare costs. This study examines the association between interpersonal attachment styles and sleep in a high-risk cohort of military veterans with PTSD symptoms.Participants were 49 military veterans (85% male) enrolled in a treatment study of combat-related sleep disturbances. Data were collected at pre-treatment baseline. Attachment anxiety and avoidance, clinical characteristics, and subjective sleep quality were characterised via self-report. Polysomnographic sleep measures were averaged from two nights of in-laboratory sleep studies and included: visually scored duration and continuity, the percentage of stage 3+4 sleep and rapid eye movement (REM) sleep, and quantitative electroencephalographic (QEEG) measures of delta and beta power during NREM and REM sleep. Linear regressions evaluated the relationship between attachment styles and sleep with adjustment for demographics, and PTSD and depressive symptoms.Greater attachment anxiety was associated with reduced percentage of stage 3+4 sleep, (?=-0.36, p<0.05) and increased relative beta power during NREM sleep (?=0.40, p<0.05). By contrast, greater attachment avoidance was positively associated with delta power during NREM and REM sleep (?=0.35 and 0.38, respectively, p<0.05).These findings suggest specific effects of interpersonal styles on physiological sleep measures. Elucidating both the neurobiological and psychological correlates of PTSD-related sleep disturbances is critical for developing future targeted intervention efforts aimed at reducing the burden of PTSD.

SUBMITTER: Troxel WM

PROVIDER: S-EPMC3367508 | biostudies-literature | 2011 Oct

REPOSITORIES: biostudies-literature

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Insecure attachment is an independent correlate of objective sleep disturbances in military veterans.

Troxel Wendy M WM Germain Anne A

Sleep medicine 20110916 9

<h4>Background</h4>Sleep disturbances and interpersonal problems are highly prevalent in military veterans with post-traumatic stress disorder (PTSD) and are associated with substantial comorbidities and increased healthcare costs. This study examines the association between interpersonal attachment styles and sleep in a high-risk cohort of military veterans with PTSD symptoms.<h4>Methods</h4>Participants were 49 military veterans (85% male) enrolled in a treatment study of combat-related sleep ...[more]

PMID: 21925945

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Project description:Study Objectives:To determine whether defining two subtypes of sleep-disordered breathing (SDB) events-with or without hypoxia-results in measures that are more strongly associated with hypertension and sleepiness. Methods:A total of 1022 participants with 2112 nocturnal polysomnograms from the Wisconsin Sleep Cohort were analyzed with our automated algorithm, developed to detect breathing disturbances and desaturations. Breathing events were time-locked to desaturations, resulting in two indices-desaturating (hypoxia-breathing disturbance index [H-BDI]) and nondesaturating (nonhypoxia-breathing disturbance index [NH-BDI]) events-regardless of arousals. Measures of subjective (Epworth Sleepiness Scale) and objective (2981 multiple sleep latency tests from a subset of 865 participants) sleepiness were analyzed, in addition to clinically relevant clinicodemographic variables. Hypertension was defined as BP ? 140/90 or antihypertensive use. Results:H-BDI, but not NH-BDI, correlated strongly with SDB severity indices that included hypoxia (r ? 0.89, p ? .001 with 3% oxygen-desaturation index [ODI] and apnea hypopnea index with 4% desaturations). A doubling of desaturation-associated events was associated with hypertension prevalence, which was significant for ODI but not H-BDI (3% ODI OR = 1.06, 95% CI = 1.00-1.12, p < .05; H-BDI OR 1.04, 95% CI = 0.98-1.10) and daytime sleepiness (? = 0.20 Epworth Sleepiness Scale [ESS] score, p < .0001; ? = -0.20 minutes in MSL on multiple sleep latency test [MSLT], p < .01). Independently, nondesaturating event doubling was associated with more objective sleepiness (? = -0.52 minutes in MSL on MSLT, p < .001), but had less association with subjective sleepiness (? = 0.12 ESS score, p = .10). In longitudinal analyses, baseline nondesaturating events were associated with worsening of H-BDI over a 4-year follow-up, suggesting evolution in severity. Conclusions:In SDB, nondesaturating events are independently associated with objective daytime sleepiness, beyond the effect of desaturating events.

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Insecure attachment is an independent correlate of objective sleep disturbances in military veterans.

Publications

Insecure attachment is an independent correlate of objective sleep disturbances in military veterans.

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