| Objectives: Clinical experiences have demonstrated a relationship between post-traumatic stress disorder(PTSD)and sleep quality.Individuals with PTSD may appear sleep quality problems,and individuals with poor sleep quality may also exhibit symptoms related to PTSD.However,the relationship and how does it change over time between PTSD(including its symptoms)and sleep remains to be further studied.In addition,few studies have explored whether they have a common neural mechanism.Therefore,the main purpose of this study is: first,explore the relationship between post-traumatic stress symptoms(PTSS)and sleep quality;second,explore the longitudinal relationship and influence path between PTSS and sleep quality;third,preliminarily explore whether traumatic exposure can cause functional abnormalities in brain and whether they are the common neural mechanism of PTSS and sleep quality.Methods: In the first part,a cross-sectional survey was conducted,PCL-5 and PSQI was used to measure PTSD symptoms and sleep quality of the subjects with COVID-19 traumatic experience.Then explore the relationship between PTSS and sleep.In the second part,we conducted a follow-up study.The subjects with contact information in the first part were followed up 12 months after traumatic experience,and PCL-5 and PSQI were used to measure PTSD symptoms and sleep quality,then explore the longitudinal relationship between PTSS(including its symptoms)and sleep.The third part used data from UK Biobank open database.We selected the data of rs-f MRI,PTSS and sleep quality.And then explore the relationship between them through network analysis in order to provide evidence for the common neural mechanism of PTSS and sleep.Results: In the first part,a total of 2341 participants were recruited from all over the country,and 2245 of them were included in the data analysis.The results showed that the percentage of people who scored above 33 in PCL-5 was 4.6%.PTSS(rs =0.437,P<0.01)and its symptoms,including intrusion(rs =0.356,P<0.01),avoidance(rs =0.236,P<0.01),negative changes in cognition and mood(rs =0.330,P<0.01),and increased alertness(rs =0.467,P<0.01)were significantly related with sleep quality.The influence factors of PTSS include sleep quality(β=0.485,P<0.001),sex(β=0.073,P<0.001),age(β=-0.065,P<0.001),isolation status(β=-0.043,P<0.05),and history of exposure to epidemic areas(β=0.047,P<0.05).In the second part,a total of 329 participants were followed up at T2(12 months after trauma).The results showed that 34 participants scored above 33 in PCL-5,with a rate of 10.3%.PTSS(t=-4.506,P<0.001)and sleep quality(t=-5.988,P<0.001)scores were significantly higher at T2 than at T1(1 month after trauma).PTSS at T1 had a significant effect on sleep quality at T2(β=0.122,P<0.05),indicating that PTSS affect the change of sleep quality.In the third part,a total of 1231 participants were selected from the open database,including 506 participants without traumatic experience and 725 participants with traumatic experience.The results showed that the trauma group have greater negative values of PFC-CC functional connectivity compared to the non-trauma group(F= 5.234,P<0.05),indicating increased antagonism between the two regions,while functional connectivity between parietal lobe and occipital lobe decreased(F=6.176,P<0.05).The results of network analysis showed that PFC-CC brain functional connectivity is associated with PTSS,it may affect sleep quality by affecting PTSS.Conclusions:(1)PTSS,including intrusion,avoidance,negative changes in cognition and mood,and increased alertness are significantly related to sleep quality.The higher level of PTSS,the worse the sleep quality.(2)The temporal relationship between PTSS and sleep quality is that PTSS at 1 month after trauma is correlated with sleep quality at 12 months after trauma,indicating that PTSS can predict changes and development of sleep quality.(3)PFC-CC brain functional connectivity may be the neural mechanism of the relationship between PTSS and sleep quality. |
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