Association of Sleep Quality, Sleep Disturbances, and Chronotype with Post-Traumatic Stress Disorder in Earthquake-Exposed Adolescents


Temelli G., DÖNMEZ Y. E.

Children, cilt.13, sa.3, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 13 Sayı: 3
  • Basım Tarihi: 2026
  • Doi Numarası: 10.3390/children13030423
  • Dergi Adı: Children
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, Directory of Open Access Journals
  • Anahtar Kelimeler: adolescence, chronotype, earthquake, post-traumatic stress disorder, sleep disturbance, sleep quality
  • İnönü Üniversitesi Adresli: Evet

Özet

Highlights: What are the main findings? Adolescents with PTSD after the 2023 Türkiye earthquakes exhibited poorer sleep quality and more pronounced sleep problems than earthquake-exposed controls. Sleep quality impairment and clinically significant sleep problems were independently associated with PTSD status and correlated with symptom severity. Evening chronotype was more frequent in adolescents with PTSD and associated with symptom severity but was not independently linked to PTSD in multivariable analyses. What are the implications of the main findings? Routine assessment of sleep disturbances may help identify adolescents at risk for persistent PTSD symptoms after disasters. Interventions targeting sleep, including cognitive behavioral therapy for insomnia and nightmare-focused treatments, may improve sleep outcomes and reduce PTSD symptom severity. Background/Objectives: Post-traumatic stress disorder (PTSD) is a common psychiatric consequence of trauma, and adolescents may be particularly vulnerable after large-scale disasters. Sleep disturbances and circadian preference may play a role in PTSD symptomatology. This study aimed to investigate the associations between PTSD, sleep quality, sleep problems, and chronotype in adolescents exposed to an earthquake. Methods: This cross-sectional study included 201 adolescents aged 12–18 years: 92 diagnosed with PTSD and 109 earthquake-exposed controls without a DSM-5 psychiatric disorder. Participants completed the Children’s Posttraumatic Stress Reaction Index (CPTS-RI), Pittsburgh Sleep Quality Index (PSQI), Children’s Sleep Habits Questionnaire (CSHQ), and Children’s Chronotype Questionnaire (CCTQ). Group differences, correlation analyses, and binary logistic regression analyses were performed. Results: Adolescents with PTSD had significantly higher CPTS-RI, PSQI, CSHQ, and CCTQ scores compared with controls (all p < 0.001), indicating poorer sleep quality, more sleep problems, and a greater tendency toward eveningness. PTSD severity was positively correlated with sleep problems, impaired sleep quality, and eveningness. In logistic regression analysis, poor sleep quality (p < 0.001) and clinically significant sleep problems (p = 0.011) were independently associated with PTSD, whereas chronotype was not. Conclusions: Sleep disturbances are more strongly associated with PTSD than chronotype in earthquake-exposed adolescents. Assessment and treatment of sleep problems may represent an important therapeutic target following large-scale trauma.