Sleep May Be Key to Health With PTSD

PTSD patients with poor sleep were less likely to be physically active

(RxWiki News) Mental health and physical health tend to be a two-way street — each can affect the other. Having PTSD can affect both, but recent research suggests some of the physical harms associated with PTSD may be the fault of another culprit.

A recent study found that veterans with post-traumatic stress disorder (PTSD) who experienced poorer sleep were less likely to be as physically active than those with better-quality sleep.

Initially, it appeared that having PTSD was the factor that led to reduced physical activity.

However, crunching the numbers on the participants' PTSD symptoms, sleep quality and physical activity a year apart revealed that poor sleep was really the culprit.

"Get sufficient sleep each night."

This study, led by Lisa Talbot, PhD, of the San Francisco VA Medical Center, explored the relationship between getting enough sleep and getting enough physical activity — specifically in individuals with PTSD. The researchers used data from 736 outpatients at two Veterans Affairs medical centers.

The participants had been assessed for PTSD symptoms and filled out questionnaires regarding their sleep quality and physical activity.

Of the group, 35 percent had current or previous PTSD. Those with PTSD reported worse sleep quality overall, which was also linked to greater depression symptoms and lower levels of physical activity.

Then, one year later, the veterans were assessed on these three measures again — PTSD symptoms, sleep quality and amount of physical activity.

The authors of this study found that reduced physical activity occurred among those who had poor sleep but didn't appear related to PTSD symptoms.

Even after taking into account age, sex, depression, weight, physical activity level at the start of the study and likelihood of having sleep apnea, the main factor related to how much physical activity the veterans got was the quality of their sleep.

As a result, the researchers concluded that the missing link in reduced physical activity among those with PTSD was actually poor sleep, not necessarily the PTSD itself.

They found that poor sleep appeared to be one mechanism leading to poorer overall health in those with PTSD.

"Worse sleep quality predicts lower physical activity in PTSD, providing possible evidence for a behavioral pathway from disturbed sleep to poor physical health outcomes," they wrote.

These findings match up with what is understood about the importance of sleep, according to William Kohler, MD, the medical director of the Florida Sleep Institute in Spring Hill, Florida.

"The previous studies have shown a possible association increased sleep and increased levels of physical activity, but the results have been inconsistent," Dr. Kohler said.

"The bottom line is that sleep is important for daily functioning," he said. "Poor quality or quantity of sleep can interfere with that functioning so we need to get sufficient sleep to function our best."

This study was published July 15 in the Journal of Clinical Sleep Medicine. The authors reported no conflicts of interest.

The research was funded by the National Heart, Lung and Blood Institute, the Irene Perstein Foundation and the Mental Illness Research and Education Clinical Center of the US Veterans Health Administration.

Review Date: 
July 21, 2014