Sleep Disturbance and PTSD Symptoms in Psychiatric Inpatients: the Role of Mindfulness Facets

Abstract

Trauma exposure and posttraumatic stress disorder (PTSD) are significant concerns across psychiatric inpatient populations. Sleep disturbance is implicated in the etiology and maintenance of PTSD. Mindfulness facets, including observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience, may have clinical relevance to sleep disturbance and PTSD. No studies to date have examined associations among sleep disturbance, mindfulness facets, and PTSD symptom severity among psychiatric inpatients. Based upon the extant literature, greater sleep disturbance and lower acting with awareness, non-judging of inner experience, and non-reactivity to inner experience were expected to be associated with greater PTSD severity; sleep disturbance was expected to exert an indirect effect on PTSD severity through acting with awareness, non-reactivity to inner experience, and non-judging of inner experience. Covariates included trauma load and number of psychiatric diagnoses. Participants included 115 trauma-exposed psychiatric inpatients (40.0% female; Mage = 33.2, SD = 10.9). During an acute-care psychiatric inpatient hospitalization, participants were administered the Mini Mental Status Examination and completed a self-report packet, which included questionnaires used in the current investigation. Greater sleep disturbance and lower describing, acting with awareness, and non-judging of inner experience facets of mindfulness were each significantly associated with greater PTSD total symptom severity. Through non-judging of inner experience, sleep disturbance exerted an indirect effect on PTSD total symptom severity and the severity of PTSD symptom clusters, including intrusion, avoidance, negative cognitions and mood, and arousal and reactivity symptoms. Future research and clinical work may target the mindfulness facet of non-judging of inner experience in order to reduce the association between sleep disturbance and PTSD symptomatology among psychiatric inpatients.