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

Post-traumatic stress disorder (PTSD) is a frequent psychiatric outcome following trauma, and adolescents may be particularly vulnerable. This cross-sectional study investigated the associations between PTSD, sleep quality, sleep problems, and chronotype in earthquake-exposed adolescents. The sample comprised 201 adolescents aged 12–18 years: 92 with PTSD and 109 earthquake-exposed controls without a DSM-5 psychiatric diagnosis. 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). 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 greater eveningness tendency. Correlation analyses showed that PTSD severity was positively associated with sleep problems, impaired sleep quality, and eveningness. In binary 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. Sleep disturbances appear to be more strongly related to PTSD than chronotype itself. Assessment and treatment of sleep problems may represent an important therapeutic target in adolescents exposed to large-scale trauma.