Sleep Quality Affects Physical Activity in PTSD

by U.S. Medicine

September 2, 2014

SAN FRANCISCO – The worse the sleep quality, the lower the physical activity levels in veterans with post-traumatic stress disorder (PTSD).

That’s according to a study from the San Francisco VAMC and the University of California, San Francisco. The research, reported recently in the Journal of Clinical Sleep Medicine, suggested that the association of reduced sleep quality with lower physical activity could comprise a behavioral link to negative health outcomes such as obesity.1

“We found that sleep quality was more strongly associated with physical activity one year later than was having a diagnosis of PTSD,” said lead author Lisa Talbot, PhD. “The longitudinal aspect of this study suggests that sleep may influence physical activity.”

Data from the Mind Your Heart Study, a prospective cohort study of 736 outpatients — 258 of whom had current or sub-syndromal PTSD — recruited from two VAMCs was used for the study. PTSD was assessed with the Clinician-Administered PTSD Scale (CAPS).

At baseline, participants rated their sleep quality overall during the last month as well as how physically active they had been. Then, their physical activity levels were reported a year later.

“Sleep quality but not PTSD status was prospectively associated with lower physical activity in a model adjusting for age, sex, apnea probability, depression, body mass index and baseline physical activity,” according to the authors. “Structural equation modeling indicated that the results were consistent with sleep quality statistically mediating the relationship between PTSD status at baseline and physical activity one year later.”

The results suggest that behavioral interventions to increase physical activity should include an assessment for sleep disturbance, Talbot noted.

“The findings also tentatively raise the possibility that sleep problems could affect individuals’ willingness or ability to implement physical activity behavioral interventions,” she said. “Sleep improvements might encourage exercise participation.”

The research was performed in collaboration with principal investigator Beth Cohen, MD, of the San Francisco VA Medical Center and the Department of Medicine at the University of California, San Francisco.

1Lisa S. Talbot, Thomas C. Neylan, Thomas J. Metzler, Beth E. Cohen. The Mediating Effect of Sleep Quality on the Relationship between PTSD and Physical Activity. Journal of Clinical Sleep Medicine, 2014; DOI: 10.5664/jcsm.3878

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