Symposia
Telehealth/m-Health
Katherine Miller, Ph.D. (she/her/hers)
Minneapolis VAMC
Minneapolis, Minnesota
Steve Woodward, PhD (he/him/his)
Clinical Psychologist
National center for PTSD, D&T division
Menlo Park, California
Phil Gehrman, PhD (he/him/his)
Clinical Psychologist
Cpl Michael J. crescenz VAMC
Philadelphia, Pennsylvania
Background: Trauma-related sleep disturbances are characterized by night-to-night variability. Advances in ambulatory sleep measurement technology make it possible to obtain passive collection of sleep measures over many nights in the usual sleep environment to fully characterize the sleep of trauma-exposed groups. The aim of this presentation is to discuss actigraphically-measured sleep and to describe its use and limitations in two samples of trauma-exposed U.S. military Veterans.
Methods: Sample one included 33 Veterans enrolled in a larger investigation examining trauma-related nightmares. Sample two included 190 Veterans engaged in a PTSD-residential treatment program. Both samples slept on mattress actigraphs, providing nightly time-in-bed sleep period and heart rate variability estimates. Descriptive statistics regarding the use and feasibility of the mattress system over one week in the home environment are used with sample one. Latent class mixed model analyses were used to identify between-subject profiles in sleep period durations over the first fifty days of residency in sample two.
Results: Data demonstrated that the system operated as intended for most participants, with a few exceptions when participants moved the equipment on their own or reported a system malfunction. Missing data primarily occurs when participants do not sleep on the equipment (e.g., vacation, sleep on couch). Overall, the system was well-tolerated by participants. When employing latent class mixed modeling analyses with the intensive longitudinal data, three longitudinal profiles of sleep period characterized most of the sample: ‘stable’ (56%), ‘decreasing’ (35%), and ‘increasing’ (8%). Less severe pre-treatment PTSD avoidance symptoms predicted membership in the 'decreasing' class and increased depression symptoms were predictive of membership in the 'increasing' class.
Conclusions: Capturing sleep across multiple nights to get a full picture of sleep patterns may inform the treatment not only of sleep-focused treatments but those, such as PTSD and depression, in which sleep symptoms figure prominently. Therefore, similar efforts to characterize sleep trajectories in other Veteran samples would be valuable.