{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:42:24Z","timestamp":1790998944415,"version":"4.1.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T00:00:00Z","timestamp":1622851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T00:00:00Z","timestamp":1622851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","award":["HT9404-13-1-0007"],"award-info":[{"award-number":["HT9404-13-1-0007"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Psychiatry"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Sleep disturbances are common in individuals with post traumatic stress disorder (PTSD). However, little is known about how daily variation in sleep characteristics is related to PTSD. This study examined the night-to-night and weekday versus weekend variation in sleep duration, sleep quality, trouble falling asleep, and difficulty staying asleep in individuals with and without PTSD.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Participants (<jats:italic>N<\/jats:italic>\u2009=\u2009157; 80 with PTSD, 77 without PTSD) completed daily self-reports of their nighttime sleep characteristics for 15 consecutive days. Linear mixed models were used to examine the associations between the 7\u2009days of the week and weekday versus weekend variation in sleep characteristics and PTSD.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Individuals with PTSD reported shorter sleep duration, lower sleep quality, more trouble falling asleep, and more difficulty staying asleep than individuals without PTSD. The pattern of change across the week and between weekdays and weekends was different between those with and without PTSD for sleep quality and trouble falling asleep. Among those with PTSD, sleep duration, sleep quality, and trouble falling asleep differed across the 7\u2009days of the week and showed differences between weekdays and weekends. For those without PTSD, only sleep duration differed across the 7\u2009days of the week and showed differences between weekdays and weekends. Neither group showed 7\u2009days of the week nor weekday versus weekend differences in difficulty staying asleep.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>On average those with PTSD had shorter sleep duration, poorer sleep quality, and greater trouble falling and staying asleep. In particular, the day of week variation in sleep quality and trouble falling asleep specifically distinguishes those with PTSD from those without PTSD. Our findings suggest that clinical care might be improved by assessments of sleep patterns and disturbances across at least a week, including weekdays and weekends. Future studies should explore the mechanisms related to the patterns of sleep disturbance among those with PTSD.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12888-021-03282-3","type":"journal-article","created":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T16:03:06Z","timestamp":1622908986000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Daily variation in sleep characteristics in individuals with and without post traumatic stress disorder"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8940-2257","authenticated-orcid":false,"given":"Quinn M.","family":"Biggs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Ursano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary H.","family":"Wynn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohul","family":"Amin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol S.","family":"Fullerton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,5]]},"reference":[{"key":"3282_CR1","doi-asserted-by":"publisher","unstructured":"Spoormaker VI, Montgomery P. Disturbed sleep in post-traumatic stress disorder: secondary symptom or core feature? Sleep Med Rev. 2008;12(3):169\u201384. https:\/\/doi.org\/10.1016\/j.smrv.2007.08.008.","DOI":"10.1016\/j.smrv.2007.08.008"},{"key":"3282_CR2","doi-asserted-by":"publisher","unstructured":"Milanak ME, Zuromski KL, Cero I, Wilkerson AK, Resnick HS, Kilpatrick DG. Traumatic event exposure, posttraumatic stress disorder, and sleep disturbances in a national sample of U.S. adults. J Trauma Stress. 2019;32(1):14\u201322. https:\/\/doi.org\/10.1002\/jts.22360.","DOI":"10.1002\/jts.22360"},{"key":"3282_CR3","doi-asserted-by":"publisher","unstructured":"Ohayon MM, Shapiro CM. Sleep disturbances and psychiatric disorders associated with posttraumatic stress disorder in the general population. Compr Psychiatry. 2000;41(6):469\u201378. https:\/\/doi.org\/10.1053\/comp.2000.16568","DOI":"10.1053\/comp.2000.16568"},{"key":"3282_CR4","doi-asserted-by":"publisher","unstructured":"Pruiksma KE, Taylor DJ, Wachen JS, Mintz J, Young-McCaughan S, Peterson AL, Yarvis JS, Borah EV, Dondanville KA, Litz BT, Hembree EA, Resick PA.. Residual sleep disturbances following PTSD treatment in active duty military personnel. Psychol Trauma Theory Res Pract Policy. 2016;8(6):697\u2013701. https:\/\/doi.org\/10.1037\/tra0000150.","DOI":"10.1037\/tra0000150"},{"key":"3282_CR5","doi-asserted-by":"publisher","unstructured":"Straus LD, Drummond SPA, Nappi CM, Jenkins MM, Norman SB. Sleep variability in military-related PTSD: a comparison to primary insomnia and healthy controls. J Trauma Stress. 2015;28(1):8\u201316. https:\/\/doi.org\/10.1002\/jts.21982.","DOI":"10.1002\/jts.21982"},{"key":"3282_CR6","doi-asserted-by":"publisher","unstructured":"McCarthy E, DeViva JC, Norman SB, Southwick SM, Pietrzak RH. Self-assessed sleep quality partially mediates the relationship between PTSD symptoms and functioning and quality of life in U.S. veterans: results from the National Health and resilience in veterans study. Psychol Trauma Theory Res Pract Policy. 2019;11(8):869\u201376. https:\/\/doi.org\/10.1037\/tra0000436.","DOI":"10.1037\/tra0000436"},{"key":"3282_CR7","doi-asserted-by":"publisher","unstructured":"American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Publishing; 2013. https:\/\/doi.org\/10.1176\/appi.books.9780890425596.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"3282_CR8","doi-asserted-by":"publisher","unstructured":"McLay RN, Klam WP, Volkert SL. Insomnia is the most commonly reported symptom and predicts other symptoms of post-traumatic stress disorder in U.S. service members returning from military deployments. Mil Med. 2010;175(10):759\u201362. https:\/\/doi.org\/10.7205\/MILMED-D-10-00193.","DOI":"10.7205\/MILMED-D-10-00193"},{"key":"3282_CR9","doi-asserted-by":"publisher","unstructured":"Zayfert C, DeViva JC. Residual insomnia following cognitive behavioral therapy for PTSD. J Trauma Stress. 2004;17(1):69\u201373. https:\/\/doi.org\/10.1023\/B:JOTS.0000014679.31799.e7.","DOI":"10.1023\/B:JOTS.0000014679.31799.e7"},{"key":"3282_CR10","doi-asserted-by":"publisher","unstructured":"Biggs QM, Ursano RJ, Wang J, Wynn GH, Carr RC, Fullerton CS. Post traumatic stress symptom variation associated with sleep characteristics. BMC Psychiatry. 2020;20(1):174. https:\/\/doi.org\/10.1186\/s12888-020-02550-y.","DOI":"10.1186\/s12888-020-02550-y"},{"key":"3282_CR11","doi-asserted-by":"publisher","unstructured":"Dietch JR, Ruggero CJ, Schuler K, Taylor DJ, Luft BJ, Kotov R. Posttraumatic stress disorder symptoms and sleep in the daily lives of world trade center responders. J Occup Health Psychol. 2019;24(6):689\u2013702. https:\/\/doi.org\/10.1037\/ocp0000158","DOI":"10.1037\/ocp0000158"},{"key":"3282_CR12","doi-asserted-by":"publisher","unstructured":"Short NA, Allan NP, Schmidt NB. Sleep disturbance as a predictor of affective functioning and symptom severity among individuals with PTSD: an ecological momentary assessment study. Behav Res Ther. 2017;97:146\u201353. https:\/\/doi.org\/10.1016\/j.brat.2017.07.014.","DOI":"10.1016\/j.brat.2017.07.014"},{"key":"3282_CR13","doi-asserted-by":"publisher","unstructured":"Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annu Rev Clin Psychol. 2008;4(1):1\u201332. https:\/\/doi.org\/10.1146\/annurev.clinpsy.3.022806.091415.","DOI":"10.1146\/annurev.clinpsy.3.022806.091415"},{"key":"3282_CR14","volume-title":"The science of real-time data capture","year":"2007","unstructured":"Stone AA, Shiffman S, Atienza AA, Nebeling L, editors. The science of real-time data capture. New York: Oxford University Press; 2007."},{"key":"3282_CR15","doi-asserted-by":"publisher","unstructured":"Biggs QM, Ursano RJ, Wang J, Krantz DS, Carr RC, Wynn GH, Probe Adams D, Dacuyan NM, Fullerton CS. Daily variation in post traumatic stress symptoms in individuals with and without probable post traumatic stress disorder. BMC Psychiatr. 2019;19(1):56. https:\/\/doi.org\/10.1186\/s12888-019-2041-7.","DOI":"10.1186\/s12888-019-2041-7"},{"key":"3282_CR16","volume-title":"The PTSD checklist for DSM-5 (PCL-5)","author":"FW Weathers","year":"2013","unstructured":"Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD checklist for DSM-5 (PCL-5); 2013. Scale available from the National Center for PTSD at http:\/\/www.ptsd.va.gov"},{"key":"3282_CR17","doi-asserted-by":"publisher","unstructured":"Bovin MB, Marx BP, Weathers FW, Gallagher MW, Rodriguez P, Schnurr PP, Keane TM. Psychometric properties of the PTSD checklist for diagnostic and statistical manual of mental disorders-fifth edition (PCL-5) in veterans. Psychol Assess. 2016;28(11):1379\u201391. https:\/\/doi.org\/10.1037\/pas0000254.","DOI":"10.1037\/pas0000254"},{"key":"3282_CR18","doi-asserted-by":"publisher","unstructured":"Buysse DJ, Reynolds 3rd CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193\u2013213. https:\/\/doi.org\/10.1016\/0165-1781(89)90047-4.","DOI":"10.1016\/0165-1781(89)90047-4"},{"key":"3282_CR19","doi-asserted-by":"publisher","unstructured":"Spoormaker VI, Verbeek I, van den Bout J, Klip EC. Initial validation of the SLEEP-50 questionnaire. Behav Sleep Med. 2005;3(4):227\u201346. https:\/\/doi.org\/10.1207\/s15402010bsm0304_4.","DOI":"10.1207\/s15402010bsm0304_4"},{"key":"3282_CR20","doi-asserted-by":"publisher","unstructured":"Aguinis H, Gottfredson RK, Culpepper SA. Best-practice recommendations for estimating cross-level interaction effects using multilevel modeling. J Manag. 2013;39(6):1490\u2013528. https:\/\/doi.org\/10.1177\/0149206313478188.","DOI":"10.1177\/0149206313478188"},{"key":"3282_CR21","doi-asserted-by":"publisher","unstructured":"Mathieu JE, Aguinis H, Culpepper SA, Chen G. Understanding and estimating the power to detect cross-level interaction effects in multilevel modeling. J Appl Psychol. 2012;97(5)951\u201366. https:\/\/doi.org\/10.1037\/a0028380.","DOI":"10.1037\/a0028380"},{"key":"3282_CR22","volume-title":"Intensive longitudinal methods: an introduction to diary and experience sampling research","author":"N Bolger","year":"2013","unstructured":"Bolger N, Laurenceau JP. Intensive longitudinal methods: an introduction to diary and experience sampling research. New York: Guilford Press; 2013."},{"key":"3282_CR23","doi-asserted-by":"publisher","unstructured":"Muth\u00e9n LK, Muth\u00e9n BO. How to use a Monte Carlo study to decide on sample size and determine power. Struct Equ Model Multidiscip J. 2002;9(4):599\u2013620. https:\/\/doi.org\/10.1207\/S15328007SEM0904_8.","DOI":"10.1207\/S15328007SEM0904_8"},{"key":"3282_CR24","volume-title":"Mplus User\u2019s Guide","author":"LK Muth\u00e9n","year":"1998","unstructured":"Muth\u00e9n LK, Muth\u00e9n BO. Mplus User\u2019s Guide. 8th ed. Los Angeles: Muth\u00e9n & Muth\u00e9n; 1998-2017.","edition":"8"},{"key":"3282_CR25","doi-asserted-by":"publisher","unstructured":"Hale L. Who has time to sleep? J Public Health. 2005;27(2):205\u201311. https:\/\/doi.org\/10.1093\/pubmed\/fdi004.","DOI":"10.1093\/pubmed\/fdi004"},{"key":"3282_CR26","doi-asserted-by":"publisher","unstructured":"Monk TH, Buysse DJ, Rose LR, Hall JA, Kupfer DJ. The sleep of healthy people\u2014a diary study. Chronobiol Int. 2000;17(1):49\u201360. https:\/\/doi.org\/10.1081\/CBI-100101031.","DOI":"10.1081\/CBI-100101031"},{"key":"3282_CR27","doi-asserted-by":"publisher","unstructured":"Taillard J, Philip P, Bioulac B. Morningness\/eveningness and the need for sleep. J Sleep Res. 1999;8(4):291\u201395. https:\/\/doi.org\/10.1046\/j.1365-2869.1999.00176.x.","DOI":"10.1046\/j.1365-2869.1999.00176.x"},{"key":"3282_CR28","doi-asserted-by":"publisher","unstructured":"Gamaldo AA, Allaire JC, Whitfield KE. Exploring the within-person coupling of sleep and cognition in older African Americans. Psychol Aging. 2010;25(4):851\u201357. https:\/\/doi.org\/10.1037\/a0021378.","DOI":"10.1037\/a0021378"},{"key":"3282_CR29","doi-asserted-by":"publisher","unstructured":"\u00c5kerstedt T, Ghilotti F, Grotta A, Zhao H, Adami HO, Trolle-Lagerros Y, Bellocco R. Sleep duration and mortality \u2013 does weekend sleep matter? J Sleep Res. 2018;28(1):e12712. https:\/\/doi.org\/10.1111\/jsr.12712.","DOI":"10.1111\/jsr.12712"},{"key":"3282_CR30","doi-asserted-by":"publisher","unstructured":"Cappuccio FP, D\u2019Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep. 2010;33(5):585\u201392. https:\/\/doi.org\/10.1093\/sleep\/33.5.585.","DOI":"10.1093\/sleep\/33.5.585"},{"key":"3282_CR31","doi-asserted-by":"publisher","unstructured":"Silva AA, Mello RB, Schaan CW, Fuchs FD, Redline S, Fuchs SC. Sleep duration and mortality in the elderly: a systematic review with meta-analysis. BMJ Open 2016;6(2):e008119. https:\/\/doi.org\/10.1136\/bmjopen-2015-008119.","DOI":"10.1136\/bmjopen-2015-008119"},{"key":"3282_CR32","doi-asserted-by":"publisher","unstructured":"Han KT, Kim SJ. Instability in daily life and depression: the impact of sleep variance between weekday and weekend in south Korean workers. Health Soc Care Commun. 2019;28(3)1\u20139. https:\/\/doi.org\/10.1111\/hsc.12918.","DOI":"10.1111\/hsc.12918"},{"key":"3282_CR33","doi-asserted-by":"publisher","unstructured":"Low TL, Choo FN, Tan SM. The efficacy of melatonin and melatonin agonists in insomnia \u2013 an umbrella review. J Psychiatr Res. 2020;121:10\u201323. https:\/\/doi.org\/10.1016\/j.jpsychires.2019.10.022.","DOI":"10.1016\/j.jpsychires.2019.10.022"},{"key":"3282_CR34","doi-asserted-by":"publisher","unstructured":"Scott H, Lack L, Lovato N. A systematic review of the accuracy of sleep wearable devices for estimating sleep onset. Sleep Med Rev. 2020;49:101227. https:\/\/doi.org\/10.1016\/j.smrv.2019.101227.","DOI":"10.1016\/j.smrv.2019.101227"},{"key":"3282_CR35","doi-asserted-by":"publisher","unstructured":"Wang YY, Yang Y, Rao WW, Zhang SF, Zeng LN, Zheng W, Ng CH, Ungvari GS, Zhang L, Xiang YT. Cognitive behavioural therapy monotherapy for insomnia: a meta-analysis of randomized controlled trials. Asia J Psychiatr. 2020;49:101828. https:\/\/doi.org\/10.1016\/j.ajp.2019.10.008.","DOI":"10.1016\/j.ajp.2019.10.008"},{"key":"3282_CR36","doi-asserted-by":"publisher","unstructured":"Dillon HR, Lichstein KL, Dautovich ND, Taylor DJ, Reidel BW, Bush AJ. Variability in self-reported normal sleep across the adult age span. J Gerontol B Psychol Sci Soc Sci. 2015;70(1):46\u201356. https:\/\/doi.org\/10.1093\/geronb\/gbu035.","DOI":"10.1093\/geronb\/gbu035"},{"key":"3282_CR37","doi-asserted-by":"publisher","unstructured":"Mezick EJ, Matthews KA, Hall M, Kamarck TW, Buysse DJ, Owens JF, Reis SE. Intra-individual variability in sleep duration and fragmentation: associations with stress. Psychoneuroendocrinology. 2009;34(9):1346\u201354. https:\/\/doi.org\/10.1016\/j.psyneuen.2009.04.005.","DOI":"10.1016\/j.psyneuen.2009.04.005"},{"key":"3282_CR38","doi-asserted-by":"publisher","unstructured":"Khawaja IS, Hashmi AM, Westermeyer J, Thuras P, Hurwitz T. Nocturnal awakening & sleep duration in veterans with PTSD: an actigraphic study. Pakistan J Med Sci. 2013;29(4):991\u201396. https:\/\/doi.org\/10.12669\/pjms.294.3831","DOI":"10.12669\/pjms.294.3831"}],"container-title":["BMC Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12888-021-03282-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12888-021-03282-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12888-021-03282-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,5]],"date-time":"2021-06-05T16:03:29Z","timestamp":1622909009000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpsychiatry.biomedcentral.com\/articles\/10.1186\/s12888-021-03282-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,5]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["3282"],"URL":"https:\/\/doi.org\/10.1186\/s12888-021-03282-3","relation":{},"ISSN":["1471-244X"],"issn-type":[{"value":"1471-244X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,5]]},"assertion":[{"value":"31 August 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was obtained from the Walter Reed National Military Medical Center and the Uniformed Services University of the Health Sciences Institutional Review Boards. Participation was voluntary and all participants provided written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"292"}}