Association of Sleep Quality, Sleep Disturbances, and Chronotype with Post-Traumatic Stress Disorder in Earthquake-Exposed Adolescents.

Background/

Objectives

Post-traumatic stress disorder (PTSD) is a common psychiatric consequence of trauma, and adolescents may be particularly vulnerable after large-scale disasters. Sleep disturbances and circadian preference may play a role in PTSD symptomatology. This study aimed to investigate the associations between PTSD, sleep quality, sleep problems, and chronotype in adolescents exposed to an earthquake.

Methods

This cross-sectional study included 201 adolescents aged 12-18 years: 92 diagnosed with PTSD and 109 earthquake-exposed controls without a DSM-5 psychiatric disorder. Participants completed the Children's Posttraumatic Stress Reaction Index (CPTS-RI), Pittsburgh Sleep Quality Index (PSQI), Children's Sleep Habits Questionnaire (CSHQ), and Children's Chronotype Questionnaire (CCTQ). Group differences, correlation analyses, and binary logistic regression analyses were performed.

Results

Adolescents with PTSD had significantly higher CPTS-RI, PSQI, CSHQ, and CCTQ scores compared with controls (all p < 0.001), indicating poorer sleep quality, more sleep problems, and a greater tendency toward eveningness. PTSD severity was positively correlated with sleep problems, impaired sleep quality, and eveningness. In logistic regression analysis, poor sleep quality (p < 0.001) and clinically significant sleep problems (p = 0.011) were independently associated with PTSD, whereas chronotype was not.

Conclusions

Sleep disturbances are more strongly associated with PTSD than chronotype in earthquake-exposed adolescents. Assessment and treatment of sleep problems may represent an important therapeutic target following large-scale trauma.