Sleep Disturbance Following September 11: Results of a Nationwide Longitudinal Study
AuthorBailey, Elaine T.
AdvisorBootzin, Richard R.
Committee ChairBootzin, Richard R.
MetadataShow full item record
PublisherThe University of Arizona.
RightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
AbstractThe terrorist attacks of September 11, 2001, provided a unique, though unfortunate, opportunity to study Americans' sleep reactions to a traumatic event. Questionnaires were distributed electronically to a web-based panel whose demographic distribution closely matched current U.S. census counts. Prior to 9/11/01, participants reported whether they had ever been diagnosed with anxiety, depression, or insomnia. Two weeks following the terrorist attacks, they completed an acute stress questionnaire (SASRQ) which included questions about 9/11-related difficulty falling or staying asleep and nightmares. They later completed a posttraumatic stress symptom questionnaire at two time points: 2 months and 6 months post-9/11. This instrument, the IES-R, included questions about 9/11-related difficulty falling asleep, difficulty staying asleep, and dreams. A total of 782 adults (50.4% male; mean age = 49.6 years) responded.Two weeks following the terrorist attacks, 23% of the sample reported having 9/11-related difficulty falling or staying asleep; 9% reported 9/11-related nightmares. Two months following the attacks, 27% reported having at least some difficulty falling asleep related to 9/11, 33% reported having difficulty staying asleep, and 17% reported having 9/11-related dreams. When assessed again at 6 months post-9/11, levels of these three sleep issues dropped significantly to 14%, 15%, and 8%, respectively. Females reported higher levels of 9/11-related sleep difficulties than males both at 2 weeks and 2 months after the attacks. By 6 months post-9/11, this sex difference had all but disappeared. Older respondents were slightly less likely than younger ones to report nightmares 2 weeks post-9/11 and dreams 2 months post-9/11. Those with pre-9/11 diagnoses of anxiety, depression, and insomnia generally had higher rates of 9/11-related sleep difficulties at all time points assessed.When tested with a hierarchical regression model, difficulty falling or staying asleep at 2 weeks post-9/11 significantly predicted posttraumatic stress symptoms experienced 6 months (but not 2 months) following the attacks. This was true even when taking into account the contribution of pre-existing psychiatric diagnoses and non-sleep-related acute stress symptoms. These findings raise the possibility that the experience of disturbed sleep soon after a trauma directly contributes to the eventual development and exacerbation of posttraumatic stress symptoms.