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Volume 15 No. 05
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Accepted Papers

Scientific Investigations

Comparison of Sleep Patterns in Vietnam Veterans With and Without Posttraumatic Stress Disorder Using Wrist Actigraphy

Rebecca Theal, BSc (Hons)1,2; Sarah McLeay, BSc (Hons), PhD1,2; Sarah Gleeson, MBBS, FRACP3,4; Fraser Lowrie, BAppSc, GradDipSSC3; Robyn O'Sullivan, MBBS, FRACP3,4; on behalf of the PTSD Initiative*
1Gallipoli Medical Research Institute, Brisbane, Queensland, Australia; 2The University of Queensland, Brisbane, Queensland, Australia; 3Sleep Care, Greenslopes Private Hospital, Brisbane, Queensland, Australia; 4Greenslopes Private Hospital, Brisbane, Queensland, Australia; *PTSD Initiative members listed in the acknowledgements

Study Objectives:

Disturbed sleep is a hallmark feature of posttraumatic stress disorder (PTSD). However, few studies have examined sleep objectively in individuals with PTSD compared to trauma-exposed controls. This study used wrist actigraphy to measure and compare sleep patterns in trauma-exposed Australian Vietnam veterans (VV) with and without PTSD.


Trauma-exposed Australian VV with and without PTSD were recruited from the PTSD Initiative. VV wore wrist accelerometers over 14 days and completed daily sleep diaries. Sleep parameters were compared between groups including sleep latency (SL), time in bed (TIB), total sleep time (TST), wake after sleep onset (WASO), and movement index (MI). Night-to-night and overall within-individual variability were assessed by root mean squared successive differences and comparison of individual standard deviations. Correlations between sleep diary (self-reported) and wrist actigraphy (objective) variables were also assessed.


A total of 40 male VV (20 with PTSD) participated in the study. We found no difference in sleep patterns determined by wrist actigraphy between groups with the exception of reduced SL in VV with PTSD (3.9 ± 0.9 versus 4.9 ± 1.4 minutes, P < .05). Overall within-individual variability was significantly greater in VV with PTSD for TIB, TST, WASO, and MI. Self-reported and objective TST and WASO were more strongly correlated in VV without PTSD than those with PTSD.


Although there were no significant differences in sleep parameters, VV with PTSD had increased within-individual overall sleep variability and reduced correlation between self-reported and objective sleep parameters compared to trauma-exposed controls. Further evaluation of extended sleep patterns by actigraphy in VV with PTSD is warranted.


Theal R, McLeay S, Gleeson S, Lowrie F, O'Sullivan R; PTSD Initiative. Comparison of sleep patterns in Vietnam veterans with and without posttraumatic stress disorder using wrist actigraphy. J Clin Sleep Med. 2019;15(5):725–732.

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