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The Mediating Effects of Sleep in the Relationship Between Traumatic Stress and Health Symptoms in Urban Police Officers

From the University of California, San Francisco; and the Department of Veterans Affairs Medical Center, San Francisco, California.

Address reprint requests to: David C. Mohr, PhD, VA Medical Center, 4150 Clement Street (116A), San Francisco, CA 94121. Email: dmohr{at}itsa.ucsf.edu

OBJECTIVE: Posttraumatic stress symptoms have been associated with increased health problems across numerous studies. Sleep disruption, one of the principal symptoms resulting from traumatic stress, has also been shown to produce health problems. This study explored the hypothesis that the relationship between posttraumatic stress symptoms and health is mediated by sleep problems.

METHOD: A sample of 741 police officers were administered measures of traumatic stress symptoms, sleep, health functioning, and somatic symptoms.

RESULTS: Traumatic stress symptoms were significantly related to both somatic symptoms (R² = 0.18, p < .001) and health functioning (R² = 0.02, p < .01). The relationship between somatic symptoms and traumatic stress symptoms was partially mediated by sleep (p < .001). The relationship between traumatic stress symptoms and health functioning was fully mediated by sleep.

CONCLUSIONS: Although design characteristics, such as cross-sectional sampling, limit the inferences that can be drawn, these findings suggest that sleep may serve as an important mediator between traumatic stress and somatic symptoms.

Key Words: posttraumatic stress, • sleep, • health, • somatic symptoms.

Abbreviations: CIHQ = Critical Incident History Questionnaire;; MAST = Michigan Alcoholism Screening Test;; MS-CV = Mississippi Scale – Civilian Version;; PSQI = Pittsburgh Sleep Quality Index;; PTSD = posttraumatic stress disorder;; SCL-90 Som = Symptom Checklist-90, Somatic Symptom Scale;; SF-12 PCS = Short-Form 12, Physical Composite Score.

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				C. R. MARMAR, S. E. MCCASLIN, T. J. METZLER, S. BEST, D. S. WEISS, J. FAGAN, A. LIBERMAN, N. POLE, C. OTTE, R. YEHUDA, et al. Predictors of Posttraumatic Stress in Police and Other First Responders Ann. N.Y. Acad. Sci., July 1, 2006; 1071(1): 1 - 18. [Abstract] [Full Text] [PDF]