The Impact of Sleep Disturbances On Arterial Stiffness in Individuals with Post-Traumatic Stress Disorder

BACKGROUND: Individuals with post-traumatic stress disorder (PTSD) frequently experience sleep disturbances, a key feature of the condition, and this may contribute to those with PTSD having a significantly higher risk of developing cardiovascular disease. An early indicator of cardiovascular disease is arterial stiffness. PURPOSE: This study aims to investigate arterial stiffness in individuals with PTSD compared to healthy controls and evaluate the association between arterial stiffness and sleep metrics. HYPOTHESIS: Individuals with PTSD will have greater arterial stiffness compared to controls, and arterial stiffness will be associated with sleep quality metrics. METHODS: A total of 23 individuals (n = 15 PTSD, 37.75 ± 2.27 yrs., n = 8 controls (CON), 35.93 ± 1.19 yrs.) were enrolled. All participants completed the post-traumatic stress disorder checklist for DSM-5 (PCL-5) to assess PTSD symptom severity and the Pittsburgh Sleep Quality Index (PSQI) and Pittsburgh Sleep Quality Index Addendum (PSQI-A) to measure sleep quality. Arterial stiffness was measured via carotid-femoral pulse wave velocity (cfPWV), and pulse wave analysis (PWA) measures including aortic pulse pressure (aPP), brachial pulse pressure (bPP), aortic mean arterial pressure (aMAP), brachial mean arterial pressure (bMAP), and augmentation index (Aix) were assessed. Independent t-tests were used to compare group means for systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), cfPWV, PCL-5, PSQI, and PSQI-A. Pearson correlations were used to evaluate the associations between arterial stiffness and sleep quality. RESULTS: There was no significant difference in SBP (t (20) = -0.52, p = 0.61), DBP (t (20) = -0.33, p = 0.75), or HR (t (20) = -1.13, p = 0.27) between PTSD and CON. There was also no significant difference between PTSD versus CON in cfPWV (t (21) = -1.41, p = 0.17, Cohen’s d = -0.62), which served as the primary metric for arterial stiffness in this study. However, there was a significant difference between PTSD versus CON in aPP (t (21) = -2.55, p = 0.02, Cohen’s d = -1.12). There was also a significant difference between PTSD vs. CON in PCL-5 scores (t (21) = -4.64, p < 0.001, Cohen’s d = -2.03), PSQI scores (t (9.41) = -2.88, p = 0.02, Cohen’s d = -1.49), and PSQI-A scores (t (20) = -3.17, p = 0.005, Cohen’s d = -1.45). PSQI was significantly correlated to aPP (r (23) = 0.43, p = 0.04) and bPP (r (23) = 0.53, p = 0.009). PSQI-A was significantly correlated to aPP (r (22) = 0.56, p = 0.007), bPP (r (22) = 0.65, p = 0.001), and cfPWV (r (22) = 0.44, p = 0.04). CONCLUSION: Contrary to our hypothesis, those with PTSD did not have significantly greater arterial stiffness. The small sample size used in our study may have prevented us from observing a significant difference in arterial stiffness in individuals with PTSD compared to controls. However, central pressure and PWV were significantly associated with measures of sleep quality, suggesting sleep disturbances may play a role in later development of cardiovascular disease. This study was funded by VA Merit I01CX001065. This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.