Does sleep mediate the association between PTSD symptoms and pain in trauma-affected refugees?

Journal of sleep research - Journal Article

Objectives/Introduction: The aim of this study was to examine if sleep disturbances mediated the association between PTSD symptoms and pain in trauma‐affected refugees. Methods: The study was based on data from a randomised controlled trial examining treatment of sleep disturbances in trauma‐affected refugees. Participants included 219 patients referred to treatment at a tertiary mental health service outpatient clinic in the Capital Region of Denmark‐the Competence Centre for Transcultural Psychiatry (CTP). Longitudinal data was used to investigate possible mediation. The participants completed self‐administered rating scales pre‐and post‐treatment. Analyses were conducted to test sleep disturbances (measured on Pittsburgh Sleep Quality Index) as a mediator between PTSD symptom severity (measured on Harvard Trauma Questionnaire) and pain severity and interference (measured on Brief Pain Inventory) controlled for demographic covariates. Mediation was analysed within a path analysis framework by conducting multiple linear regression. Results: Results from analysis on bivariate relationships among study variables demonstrated that sleep disturbances were significantly associated with pain interference and PTSD symptom severity (p < 0.05 for each) Conclusions: Sleep disturbances are associated with both pain interference and PTSD symptom severity. The study is the first to investigate if sleep is a mediator of the association between PTSD and pain in trauma‐affected refugees and thus contributes with new knowledge and possible clinical implications for treatment of sleep disturbances and symptoms of pain in trauma‐affected refugees.

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