0125 Sleep Reactivity Predicts Subjective but not Actigraphy-Derived Sleep Disturbances in Trauma-Exposed Adults

Abstract Introduction Sleep reactivity is a vulnerability to sleep disturbance after stress. Research shows sleep reactivity may be more consistently associated with self-reported rather than actigraphy-derived sleep disturbances in healthy and clinical samples. This “sleep-state misperception” is commonly seen in Posttraumatic Stress Disorder (PTSD), yet it is unknown whether sleep reactivity differentially correlates with subjective versus objective sleep in PTSD. The current study investigated the association between sleep reactivity and sleep disturbances assessed via questionnaires, daily diaries, and actigraphy in trauma-exposed individuals. Methods Participants (N= 129) who had experienced a DSM-5 Criterion A trauma in the past two years, but not prior month, and representing the full spectrum of posttraumatic sequelae were studied (65 meeting PTSD criteria, CAPS-5 mean 30.58; 64 sub-threshold, CAPS-5 mean 11.06). In addition to CAPS-5, participants completed the Ford Insomnia Response to Stress Test (FIRST), Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), PSQI-PTSD Addendum (PSQI-PTSD), and 14-days of sleep diaries and actigraphy. Results The FIRST correlated with all self-reported sleep measures: ISI (r= .47, p .001), PSQI (r= .29, p .01), PSQI-PTSD (r= .31, p .001), diary sleep efficiency (SE; r= -.25, p .01), and sleep onset latency (SOL; r= .21, p .05) except diary total sleep time (TST; p .05). The FIRST was not associated with the corresponding actigraphy-derived sleep parameters (ps .05). Controlling for PTSD severity (CAPS-5), the FIRST still predicted ISI (β= .45, p= .002), PSQI (β= .09, p= .06), PSQI-PTSD (β= .12, p= .06), but not diary SE (β= -.17, p= .12) or diary SOL (β= .40, p= .16). Conclusion Sleep reactivity was consistently associated with subjective, but not objective, sleep disturbances, suggesting that self-reported sleep reactivity may manifest primarily in perceived sleep difficulties. Alternatively, sleep reactivity may only be associated with actigraphy on nights after participants experience stressors. The FIRST predicted subjective sleep complaints above and beyond PTSD severity, underscoring its value as an index of sleep vulnerability that is distinct from PTSD-related hyperarousal. Findings highlight the importance of assessing both subjective and objective sleep outcomes, as each may capture distinct processes contributing to stress-related sleep problems. Support (if any)