Trauma and Stressor Related Disorders and Disasters
PTSD Symptoms are Associated with High Levels of Fear of Sleep in Trauma-Exposed Individuals Who Use Cannabis
Jessica Y. Choi, M.S.
Research Analyst II
Center for Human Systems Immunology, Duke School of Medicine; Department of Anesthesiology, University of North Carolina at Chapel Hill School of Medicine; Institute for Trauma Recovery
Durham, North Carolina
Kaathya Kashyap, None
Student researcher
Department of Anesthesiology, University of North Carolina at Chapel Hill School of Medicine; Institute for Trauma Recovery
Chapel Hill, North Carolina
Norman Schmidt, Ph.D.
Professor
Florida State University
Tallahasse, Florida
Nicole A. Short, Ph.D.
Assistant Professor
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina
Background: Individuals with posttraumatic stress disorder (PTSD) symptoms often experience insomnia, placing them at risk for worse presentations of PTSD, including comorbid substance use disorder. Indeed, substances such as cannabis are often used to cope with PTSD and insomnia symptoms. Although theoretical models suggest PTSD symptoms may be associated with fear of sleep, exacerbating insomnia symptoms, little empirical work has explored this topic, particularly in substance-using individuals. The current study cross-sectionally tested the hypothesis that PTSD symptoms are associated with fear of sleep and its subfactors among trauma-exposed cannabis users after covarying for insomnia symptoms and cannabis use frequency.
Methods: Undergraduate and community participants who were recruited for larger randomized clinical trial testing of an insomnia treatment for trauma-exposed cannabis users (N= 56; Mage=20.70, SD= 3.93, 58.9% women) were assessed at baseline prior to randomization and treatment onset. Participants self-reported PTSD (PTSD Checklist-5 with sleep items removed) and insomnia symptoms (Insomnia Severity Index), fear of sleep (Fear of Sleep Inventory), and cannabis use frequency (Cannabis Use Disorder Identification Test).
Results: Regression models with insomnia symptoms and cannabis use frequency as covariates suggested that PTSD symptoms were significantly associated with fear of sleep total scores (β=.57, t=4.36, p< .001, sr2=.36) and all subscales (fears of loss of control, nightmares, re-experiencing trauma, and loss of vigilance; vigilant behaviors, p< .001), with the exception of fear of the dark (p=.435).
Conclusion: Our study replicates prior research suggesting PTSD symptoms are associated with higher levels of fear of sleep and expands upon prior work by including a cannabis using sample. Future research should utilize prospective and experimental designs to explore temporal associations between PTSD symptoms, fear of sleep, and insomnia, and whether targeting fear of sleep reduces insomnia symptoms.
Funding Source: F31DA044689-01
