A - 73 The Impact of Posttraumatic Stress Disorder on Cognitive Health in 9/11 Responders: the Role of Sleep Disturbances.

Abstract

PTSD is known to have a long-term impact on cognitive health, specifically executive dysfunction. However, most studies have not tested possible mechanisms underpinning this association. Sleep disturbances have emerged as a potential pathway between PTSD and cognitive functioning. This study aimed to investigate whether sleep disturbances account for the association between PTSD and executive dysfunction in trauma-exposed first responders. Participants consisted of 9/11 WTC responders (N = 452, mean age = 55.22, SD = 8.73, 89% male, 90% White). Data collection occurred across 3 time points, each 1year apart. Measures included self-reported PTSD and insomnia symptoms, two weeks of Ecological Momentary Assessment of sleep duration and sleep quality, and the Trail Making Test part B. Due to high stability across 3years, the present study focused on mean, trait-like variables. Analyses adjusted for demographics, BMI, and trauma exposure severity. PTSD was associated with Trail Making Test part B (r = 0.10, p = 0.03), as well as insomnia (r = 0.63, p < 0.00) and sleep quality (r = -0.45, p < 0.00), but not sleep duration. Mediation analyses revealed that sleep quality fully accounts for the significant association between PTSD and executive functioning (indirect effect β= 0.056, p = 0.041, 95% CI [0.009, 0.108]). The current results highlight the important role that disturbances in sleep may have on cognitive health outcomes. Improving sleep, in the context of PTSD, could attenuate cognitive symptoms, and possibly protect against further decline. Future research conducted in the acute phase of trauma-exposure and PTSD is needed to clarify the directionality of these relationships, with longitudinal analyses that will allow form modeling cognitive decline.