Holistic approaches to trauma rehabilitation for forced migrants: assessing sleep as an associated factor for mental health, pain, and cardiovascular health.

INTRODUCTION

Forced migrants experience trauma that adversely affects their health, leading to disproportionately high rates of sleep disturbance. Despite this burden, gaps remain in sleep research, clinical training, and the development of treatment protocols for this population. Likewise, limited research exists on the bidirectional relationship between sleep and other prevalent conditions in this population. This study assessed the relationship of sleep quality with anxiety, depression, post-traumatic stress disorder (PTSD), chronic pain, blood pressure, resting heart rate, and heart rate variability in a forced migrant population. It also reports on associations of sleep quality with trauma exposure and social participation.

MATERIALS AND

METHODS

This was a cross-sectional study of 65 forced migrants who have at least mild chronic pain. Partial correlations were conducted with sleep quality and each outcome, controlling for age, body mass index (BMI), sex, length of time in the United States, and length of services at two trauma rehabilitation clinics.

RESULTS

Participants experienced high rates of poor sleep (92.3%). Sleep quality scores were significantly associated with PTSD, depression, anxiety, and chronic pain but not blood pressure, resting heart rate, or heart rate variability. Trauma exposure was significantly associated with poorer sleep quality, whereas social participation was associated with better sleep quality.

CONCLUSION

Sleep quality was significantly associated with PTSD, anxiety, depression, and chronic pain in forced migrants and may represent an important clinical target in trauma rehabilitation. The contribution of this study is documenting these associations within a forced migrant population, where sleep remains understudied. Future work should develop and test sleep interventions adapted for the needs and context of forced migrants.