{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:03:47Z","timestamp":1790298227488,"version":"4.1.0"},"reference-count":57,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["IK2 CX001774"],"award-info":[{"award-number":["IK2 CX001774"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["IK2 CX001787"],"award-info":[{"award-number":["IK2 CX001787"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["IK4 BX006799"],"award-info":[{"award-number":["IK4 BX006799"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Sleep disruption is a common hallmark of posttraumatic stress disorder (PTSD), causing significant distress and often persisting after remission of other symptoms. Autonomic dysregulation is commonly comorbid and has been implicated in the underlying pathophysiology of both wake\u2010 and sleep\u2010related symptoms following trauma. However, existing self\u2010report tools for nightmares and trauma\u2010related sleep disruption place relatively little emphasis on autonomic symptoms such as palpitations and sweating, limiting our ability to gauge these features quantitatively, assess their impact on sleep, and track their response to treatment. Here, we describe the initial validation of a novel exploratory 11\u2010item self\u2010report measure, the Seattle Trauma and Autonomic Related Sleep Symptoms (STARSS) Scale, developed to assess trauma\u2010related sleep disruption including nightmares and autonomic hyperarousal symptoms. Psychometric validation of the STARSS was assessed in a sample of 830 healthcare workers and first responders working during the COVID\u201019 pandemic. The full scale (STARSS\u201011) positively correlated with self\u2010report measures of symptom domains often associated with nightmares and commonly elevated following trauma exposure including PTSD (PCL\u20105;\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.76), anxiety (GAD7;\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.65), depression (PHQ9;\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.63), and insomnia (ISI;\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u20090.56), and displayed strong internal consistency (\n                    <jats:italic>\u03b1<\/jats:italic>\n                    \u2009=\u20090.89;\n                    <jats:italic>\u03c9<\/jats:italic>\n                    \u2009=\u20090.93). The STARSS\u201011 is well\u2010fit by a 4\u2010factor model: hyperarousal upon waking, trauma dream intensity, and self\u2010 and partner\u2010reported excessive physical activity during sleep. An item\u2010reduced STARSS\u20109 with 3 factors is also described. These outcomes suggest STARSS is a promising tool for the assessment of sleep disturbance related to trauma and dysautonomia in research settings.\n                  <\/jats:p>","DOI":"10.1111\/jsr.70439","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:55:10Z","timestamp":1790297710000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Seattle Trauma and Autonomic Related Sleep Symptoms (\n                    <scp>STARSS<\/scp>\n                    ) Scale: A Novel Self\u2010Report Measure of Sleep Disturbances With Nightmares and Autonomic Symptoms Following Trauma"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7449-2832","authenticated-orcid":false,"given":"Garth E.","family":"Terry","sequence":"first","affiliation":[{"name":"Department of Veterans Affairs, Puget Sound Health Care System Mental Illness Research, Education, and Clinical Center (MIRECC)  Seattle Washington USA"},{"name":"Department of Psychiatry &amp; Behavioral Sciences University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron F.","family":"Rosser","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Puget Sound Health Care System Mental Illness Research, Education, and Clinical Center (MIRECC)  Seattle Washington USA"},{"name":"Department of Psychiatry &amp; Behavioral Sciences University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine J.","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Puget Sound Health Care System Mental Illness Research, Education, and Clinical Center (MIRECC)  Seattle Washington USA"},{"name":"Department of Psychiatry &amp; Behavioral Sciences University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim L.","family":"Hart","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Puget Sound Health Care System Mental Illness Research, Education, and Clinical Center (MIRECC)  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1303-8107","authenticated-orcid":false,"given":"Sarah B.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Sciences University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murray A.","family":"Raskind","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Puget Sound Health Care System Mental Illness Research, Education, and Clinical Center (MIRECC)  Seattle Washington USA"},{"name":"Department of Psychiatry &amp; Behavioral Sciences University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca C.","family":"Hendrickson","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Puget Sound Health Care System Mental Illness Research, Education, and Clinical Center (MIRECC)  Seattle Washington USA"},{"name":"Department of Psychiatry &amp; Behavioral Sciences University of Washington School of Medicine  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14399"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.8758"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1389\u20109457(00)00065\u20104"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e3181961d8e"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22059"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pra.0000265763.79753.c1"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/DRM0000178"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15\u20100903"},{"key":"e_1_2_13_10_1","first-page":"1","article-title":"Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most From Your Analysis","volume":"10","author":"Costello A. 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