Evaluation of sleep quality and quality of life in female adolescents with post-traumatic stress disorder related to sexual abuse

Aim: Being subjected to sexual abuse in adolescence causes many negative consequences in long term. Posttraumatic stress disorder (PTSD) which is one of that many consequences can lead to disturbances in adolescence's quality of life. This study aims to evaluate sleep quality of adolescents with PTSD related to sexual abuse and to investigate the relationship betwen sleep quality, PTSD semptoms and quality of life. Method: Our study was designed as a cross-sectional study. 40 adolescents who were diagnosed with PTSD related to sexual abuse (case group) and 40 healthy adolescents as control group were included in the study. Structured interview scales of Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime (the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS) were applied to children by the clinician. All participants also filled out Sociodemographic information form, Pediatric Quality of Life Inventory (PedsQL), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI). Results: The analyses of the data revealed that quality of life scores of case group were significantly associated with worse results (p<0,001). Sleeplesness index(ISI), morning sleepiness scores(ESS) were higher in the case group in comparison to control group (p<0,001; p<0,001) and percieved quality of sleep (PUKİ) was determined to be lower (p<0,001). A statistically significant positive correlation between PSQI and CAPS-CA-B subgroup was identified (p<0,019) and a statistically significant positive correlation between other scales that measure CAPS-CA was also determined. There was a statistically significant positive correlation between ESS and CAPS-CA-B and CAPS-Impairment in social functioning(ISF) ( p<0,001 and p<0,001 respectively). There was a positive correlation between ESS and CAPS-CA-D and CAPS-total points (p<0,020 and p<0,019 respectively). In addition, there was a statistically significant positive correlation between ISI and CAPS-CA-B subgroup (p<0,015), and also a statistically significant positive correlation between CAPS-CA-C, CAPS-CA-Subjective distress(SD) and CAPS-CA-ISF scales were determined (p<0,001; p<0,001; p<0,001 respectively). Furthermore, there was a positive correlation between CAPS-CA-D and CAPS-total scores ( p<0,001; p<0,001 respectively). Statistically significant relationship between PTSD and PSQI, ESS, ISI and PedsQL were identified (p<0,001). PSQI, ESS and ISI were also found to be correlated with each other. There was a moderate positive correlation between PSQI and ESS (p<0,001). A strong, statistically significant correlation between PSQI and ISI were detected (p<0,001). There was a moderate positive correlation between ESS and ISI (p<0,001). Conclusion: In cases with PTSD related to sexual abuse, we found that sleep affects the quality of life more than the symptoms of PTSD. Sleep based approaches in PTSD may affect both quality of life and functionality positively and PSQI may be used in clinical practice to assess both sleep and quality of life in the follow up of patients with PTSD related to sexual abuse.