TY - JOUR
T1 - Actigraphic sleep monitoring in patients with post-traumatic stress disorder (PTSD)
T2 - A meta-analysis
AU - Lam, Lam
AU - Ho, Fiona Yan Yee
AU - Wong, Vincent Wing Hei
AU - Chan, Ka Wai
AU - Poon, Chun Yin
AU - Yeung, Wing Fai
AU - Chung, Ka Fai
N1 - Funding Information:
Lam Lam received student research support from the Chinese University of Hong Kong . The funding source had no involvement in study design, collection, analysis and interpretation of data, writing of the report, or the decision of article submission for publication.
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Objective: Sleep disruption is a common complaint among patients with post-traumatic stress disorder (PTSD). Modern technology of activity monitoring (actigraphy) enables extended, objective, unobtrusive recording and measuring of daytime and nighttime activity. We conducted a meta-analysis to investigate the actigraphic sleep patterns in PTSD compared with healthy controls. Methods: We searched through seven electronic databases from inception to July 2022. Only case-control studies comparing rest-activity variables measured by actigraphy devices between clinically diagnosed PTSD patients and healthy individuals were included. Results: We identified 12 eligible studies comparing 323 PTSD patients and 416 healthy controls. Using a random-effects model, we showed that PTSD patients have significantly lower sleep efficiency (SMD: −0.26, 95 % CI = −0.51 to −0.004, p < .05, I2 = 29.31 %), more fragmented sleep (SMD: 0.52, 95 % CI = 0.17 to 0.87, p < .01, I2 = 0 %), and longer time in bed (SMD: 0.41, 95 % CI = 0.07 to 0.74, p < .05, I2 = 0 %) compared to healthy controls. Limitations: This study included a limited number of studies. Publication bias was not examined on all variables, which could lead to an overestimation of effect size. Four studies involved veterans, which likely differ from civilians regarding traumatic exposure. Conclusion: This meta-analytic review highlighted a pattern of sleep disturbances in PTSD patients compared with non-PTSD individuals. High-quality, large-scale studies are necessary to draw a definitive conclusion regarding the distinctive sleep profile in PTSD. Future research can pay attention to sleep-specific mechanisms underlying PTSD and explore the momentary interactions between sleep-wake variables.
AB - Objective: Sleep disruption is a common complaint among patients with post-traumatic stress disorder (PTSD). Modern technology of activity monitoring (actigraphy) enables extended, objective, unobtrusive recording and measuring of daytime and nighttime activity. We conducted a meta-analysis to investigate the actigraphic sleep patterns in PTSD compared with healthy controls. Methods: We searched through seven electronic databases from inception to July 2022. Only case-control studies comparing rest-activity variables measured by actigraphy devices between clinically diagnosed PTSD patients and healthy individuals were included. Results: We identified 12 eligible studies comparing 323 PTSD patients and 416 healthy controls. Using a random-effects model, we showed that PTSD patients have significantly lower sleep efficiency (SMD: −0.26, 95 % CI = −0.51 to −0.004, p < .05, I2 = 29.31 %), more fragmented sleep (SMD: 0.52, 95 % CI = 0.17 to 0.87, p < .01, I2 = 0 %), and longer time in bed (SMD: 0.41, 95 % CI = 0.07 to 0.74, p < .05, I2 = 0 %) compared to healthy controls. Limitations: This study included a limited number of studies. Publication bias was not examined on all variables, which could lead to an overestimation of effect size. Four studies involved veterans, which likely differ from civilians regarding traumatic exposure. Conclusion: This meta-analytic review highlighted a pattern of sleep disturbances in PTSD patients compared with non-PTSD individuals. High-quality, large-scale studies are necessary to draw a definitive conclusion regarding the distinctive sleep profile in PTSD. Future research can pay attention to sleep-specific mechanisms underlying PTSD and explore the momentary interactions between sleep-wake variables.
KW - Actigraphy
KW - Case-control
KW - Meta-analysis
KW - Post-traumatic stress disorder
KW - Sleep
UR - http://www.scopus.com/inward/record.url?scp=85139422140&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2022.09.045
DO - 10.1016/j.jad.2022.09.045
M3 - Review article
C2 - 36174789
AN - SCOPUS:85139422140
SN - 0165-0327
VL - 320
SP - 450
EP - 460
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -