0930 Trauma-Specific and Nonspecific Predictors of Sleep-State Misperception Among Trauma-exposed Women

Abstract Introduction Sleep disturbances are highly prevalent following trauma exposure but tend to persist following trauma-focused treatment, which brings into question the relevance of trauma-specific factors in these sleep problems. Sleep assessment can include subjective methods, like sleep diaries, and/or objective methods, like actigraphy. However, these methods tend to result in low-moderate concordance, and it has been hypothesized that clinical samples report greater sleep disturbance than objective methods record (i.e., sleep-state misperception). This may be due to greater overall distress or bias from experiencing clinical symptoms. This study examined trauma-specific and nonspecific predictors of sleep-state misperception in trauma-exposed women. Methods N=55 cis-gendered women with a self-reported history of sexual abuse in childhood (between ages 6-11) completed baseline surveys assessing sleep and mental health, and one week of sleep monitoring via actigraphy and sleep diaries as part of a larger study. Cohen’s d was calculated to estimate the degree of sleep-state misperception between sleep diary and actigraphy. Results Participants tended to overestimate total sleep times (TST) and sleep onset latencies (SOL) when reported on sleep diary compared to actigraphy. In contrast, participants underestimated wake after sleep onset (WASO) via sleep diary compared to actigraphy. In examining clinical correlates of sleep-state misperception, we found that TST Cohen’s d was significantly correlated with baseline depressive symptoms (r=.295, p=.029) and pre-sleep cognitive arousal (r=.269, p=.047). PTSD hyperarousal symptoms (minus the sleep item) were positively correlated with TST Cohen’s d (r=.358, p=.007) but negatively correlated with SOL Cohen’s d (-.279, p=.039). Conclusion While we observed both trauma-specific (i.e., hyperarousal) and nonspecific (i.e., depression, cognitive arousal) to be associated with sleep-state misperception, it is possible that these variables have similar underlying transdiagnostic factors. For example, rumination (a form of perseverative cognition focused on negative content) underlies both depression and PTSD. Future work should further probe contributing factors to sleep-state misperception to better understand this phenomenon. Support (if any) This study was funded by the University of Houston Small Grants Program (PI: CAA). CJS was supported by the Department of Veterans Affairs, Office of Academic Affiliations, Advanced Fellowship in Mental Illness Research and Treatment, and the University of Houston Dissertation Completion Fellowship.