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A multi-component cognitive-behavioral intervention for sleep disturbance in veterans with PTSD: a pilot study
Christi S Ulmer1, Jack D Edinger, Patrick S Calhoun
1Durham Veterans Affairs Medical Center, Durham, NC 27705, USA. christi.ulmer@va.gov
Summary
A combined therapy for posttraumatic stress disorder (PTSD) and insomnia significantly improved sleep and reduced PTSD symptoms in veterans. This trauma-focused intervention shows promise for addressing comorbid sleep disturbances.
Area of Science:
- Sleep Medicine
- Psychiatry
- Military Health
Background:
- Trauma-related sleep disturbance is prevalent in US military personnel post-deployment.
- Disrupted sleep is linked to medical conditions in individuals with posttraumatic stress disorder (PTSD).
- Existing treatments for PTSD and insomnia, including Cognitive Behavioral Therapy for Insomnia (CBT-I), often leave residual sleep difficulties.
Purpose of the Study:
- To evaluate a combined intervention for trauma-specific sleep disturbance in veterans with PTSD.
- To assess the efficacy of integrating CBT for insomnia with a nightmare-specific intervention.
Main Methods:
- A study involving 22 veterans diagnosed with PTSD.
- A combined intervention of CBT for insomnia and imagery rehearsal therapy was compared to usual care.
Main Results:
- The combined intervention demonstrated medium to large effect sizes for sleep diary outcomes.
- Very large treatment effects were observed for insomnia severity, sleep quality, and PTSD symptoms.
Conclusions:
- The targeted intervention for trauma-specific sleep disturbance yielded significant short-term reductions in PTSD symptoms and insomnia severity.
- Future research should explore optimal sequencing of treatments for comorbid PTSD and sleep disturbance.
- Ensuring the availability and acceptability of sleep interventions for younger veterans is crucial.
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