ArticleJournal of traumatic stress2025
Examining the between- and within-person associations among perceived sleep quality and mental health symptoms in emergency medical service clinicians.
Article in Journal of traumatic stress, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of the prevalence, risk factors, and protective factors of posttraumatic stress disorder among paramedics.Journal of traumatic stress · 2026Pooled it
- Scoping Review of Experience Sampling Methodology Investigations of Posttraumatic Stress Disorder Symptoms.Clinical psychology : a publication of the Division of Clinical Psychology of the American Psychological Association · 2026Article
- Examining the between- and within-person associations among perceived sleep quality and mental health symptoms in emergency medical service clinicians.Journal of traumatic stress · 2025Article
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Authors and funding
8 authors.
Funding
Abstract
Disturbed sleep is a known risk factor for heightened mental health symptoms, and this association may be particularly problematic among emergency medical service (EMS) clinicians. Yet, associations between daily sleep quality and daily mental health symptoms are understudied among this vulnerable group. We used ecological momentary assessments to examine between- and within-person associations between perceived sleep quality and mental health symptoms in 79 EMS clinicians employed at a large agency in central New York. Participants completed eight daily assessments (558 total) on perceived sleep quality and symptoms of posttraumatic stress disorder (PTSD) and depression. Multilevel regression models examined between- and within-person effects of sleep quality, controlling for covariates. Between-person effects in each model accounted for 17.0% and 31.0% of the total variance, respectively; within-person effects explained 1.0% per model. Poorer between-person perceived sleep quality was associated with higher PTSD and depressive symptom severity; perceived sleep quality 1.0 standard deviation (SD) below the sample mean was related to 58.8% and 16.3% increases in PTSD and depressive symptoms, respectively. There was also a within-person effect for depressive symptoms: On days when a participant's perceived sleep quality was 1.0 SD below their average, depressive symptom severity increased by 3.0%. Poorer subjective sleep may be an important risk factor for mental health symptoms at the between-person level. EMS policies supporting healthy sleep may benefit clinicians who routinely experience poor sleep. Day-to-day subjective sleep quality may increase the risk for depressive symptoms. Interventions to improve sleep and manage depressive symptom fluctuations when sleep is poor might be helpful.
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