(PS11-B34) Associations Between Anxiety Sensitivity and Sleep Disturbances in Adults with Probable PTSD and Alcohol Use Disorder

Anxiety sensitivity (AS) has been conceptualized as a valuable mechanistic target for influencing health behaviors, including sleep. AS predicts sleep disruption and moderates the influence of proximal stressors on sleep. Further, targeted treatment of AS benefits sleep. Sleep is related to several psychological disorders, including posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and depression. In this study, we examine the role of AS in predicting sleep disruption—as both a main effect and in moderating the predictive influence of traumatic stressors—among those with probable PTSD and AUD. Participants were 521 trauma-exposed adults (51.2% women, 69.3% Non-Hispanic White, average age = 38.9 years ± 10.8 years) with probable PTSD and AUD, recruited nationally. Participants completed a cross-sectional survey in the context of a Qualtrics-based remote study. Using multiple regression analyses, we examined the predictive significance of AS on two indices of sleep disruption assessed: using total sleep duration as a primary outcome and subjective sleep quality as a secondary outcome. Age, sex, and race/ethnicity were included as covariates in all analyses. Trauma load significantly predicted sleep duration only. The main effect of AS was incrementally associated with sleep duration and sleep quality (ps< .002); higher AS was associated with poorer sleep. The interaction of AS with trauma load was significantly related to sleep quality only (p=.016); showing the association between AS and sleep quality was evident only in individuals with lower trauma load. We subsequently examined whether AS was uniquely associated with sleep outcomes in the context of depression, PTSD, and AUD severity. Regarding sleep duration, significant prediction provided by AS was eliminated by consideration of depression severity. Regarding sleep quality, the incremental association of AS was significant after accounting for the variance contributed by trauma load, depressive symptoms, PTSD symptoms, and alcohol use severity. These data support the potential role of AS as an intervention target for those with sleep disturbances in the context of probable PTSD and AUD, albeit all associations reflected small effect sizes. Brief interventions for AS have been validated in both prevention and intervention models and may be usefully applied in future research.