Marital quality, PTSD symptomatology, and sleep: A study of aging Veterans from the RISE study

Abstract:Spousal relationships are proximal social influences on partnered (i.e., married or cohabitating) older adults’ sleep, often acting either as a protective or risk factor for sleep quality depending upon the relationship quality. However, there is limited research examining how contextual factors–such as symptoms of post-traumatic stress disorder (PTSD)--may moderate linkages between spousal relationships and sleep among older adults. The current study therefore aims to examine links between marital quality (i.e., emotional support and affectionate touch) and sleep (i.e., subjective self- report of sleep disturbances/quality), and how daily variations in marital quality are associated with aging veterans’ (65+ years old) sleep quality. This study will further consider the moderating role of veterans’ PTSD symptoms. Data came from a convenience sample of aging veterans recruited nationally for the RISE (Relational Influence on Sleep & Emotion) Study. To participate, Veterans had to be at least 65 years old and be married or living with a partner (N = 70; n = 67 males). Marital and sleep quality were measured at an initial baseline survey and daily surveys completed within two hours of going to sleep.Participants completed up to 7 daily surveys wherein they reported their daily interactions with their partners and the subjective quality of their sleep the previous night. Regarding the baseline analyses results, neither spousal emotional support nor affectionate touch support were associated with sleep. Regarding the daily analyses, aging Veterans who reported higher levels of spousal emotional support on average among the sample (between-person predictor) also reported higher levels of sleep quality across the week. However, this association was no longer significant once PTSD (or the PTSD subclusters: Reexperiencing, Avoidance, Negative Affect, Hyperarousal) was included in the model. A significant interaction emerged between affectionate touch and the PTSD subcluster of Negative Affect: On days when Veterans reported more affectionate touch than usual (within-person predictor), they reported lower levels of sleep quality that night, with this association being stronger among those with high (versus low) levels of Negative Affect. Collectively, these findings highlight aspects of marital quality that may have unique implications for the sleep of aging Veterans.