{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:50:55Z","timestamp":1780638655630,"version":"3.54.1"},"reference-count":58,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["1F31DA062393\u201001"],"award-info":[{"award-number":["1F31DA062393\u201001"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Traumatic Stress"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Disturbed sleep is a known risk factor for heightened mental health symptoms, and this association may be particularly problematic among emergency medical service (EMS) clinicians. Yet, associations between daily sleep quality and daily mental health symptoms are understudied among this vulnerable group. We used ecological momentary assessments to examine between\u2010 and within\u2010person associations between perceived sleep quality and mental health symptoms in 79 EMS clinicians employed at a large agency in central New York. Participants completed eight daily assessments (558 total) on perceived sleep quality and symptoms of posttraumatic stress disorder (PTSD) and depression. Multilevel regression models examined between\u2010 and within\u2010person effects of sleep quality, controlling for covariates. Between\u2010person effects in each model accounted for 17.0% and 31.0% of the total variance, respectively; within\u2010person effects explained 1.0% per model. Poorer between\u2010person perceived sleep quality was associated with higher PTSD and depressive symptom severity; perceived sleep quality 1.0 standard deviation (SD) below the sample mean was related to 58.8% and 16.3% increases in PTSD and depressive symptoms, respectively. There was also a within\u2010person effect for depressive symptoms: On days when a participant's perceived sleep quality was 1.0 SD below their average, depressive symptom severity increased by 3.0%. Poorer subjective sleep may be an important risk factor for mental health symptoms at the between\u2010person level. EMS policies supporting healthy sleep may benefit clinicians who routinely experience poor sleep. Day\u2010to\u2010day subjective sleep quality may increase the risk for depressive symptoms. Interventions to improve sleep and manage depressive symptom fluctuations when sleep is poor might be helpful.<\/jats:p>","DOI":"10.1002\/jts.23180","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T01:49:38Z","timestamp":1749692978000},"page":"781-792","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Examining the between\u2010 and within\u2010person associations among perceived sleep quality and mental health symptoms in emergency medical service clinicians"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9701-8925","authenticated-orcid":false,"given":"Enzo G.","family":"Plaitano","sequence":"first","affiliation":[{"name":"Center for Technology and Behavioral Health Dartmouth College  Lebanon New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1146-2986","authenticated-orcid":false,"given":"Shengzi","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Beth Israel Deaconess Medical Center  Boston Massachusetts USA"},{"name":"Division of Sleep Medicine Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2901-7896","authenticated-orcid":false,"given":"Mariel","family":"Emrich","sequence":"additional","affiliation":[{"name":"Department of Psychological Sciences University of Connecticut  Storrs Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7472-5878","authenticated-orcid":false,"given":"Emily E.","family":"Patton","sequence":"additional","affiliation":[{"name":"Department of Psychology Georgia State University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4993-7836","authenticated-orcid":false,"given":"E. 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