Augmenting cognitive processing therapy to improve sleep impairment in PTSD: A randomized controlled trial

Area of Science:

• Psychology
• Psychiatry
• Sleep Medicine

Background:

• Sleep impairment is a common and persistent issue for individuals with posttraumatic stress disorder (PTSD), often remaining unresolved even after standard treatments.
• Empirically supported treatments for PTSD, such as cognitive processing therapy (CPT), have shown success, but sleep disturbances frequently persist.

Purpose of the Study:

• To investigate the effectiveness of sleep-directed hypnosis as an adjunctive therapy to cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD).
• To determine if hypnosis improves sleep, PTSD symptoms, and depression, and if sleep improvements mediate changes in PTSD and depression during CPT.

Main Methods:

• A single-site, randomized controlled trial involving participants with PTSD.
• Participants were assigned to either 3 weeks of hypnosis or a symptom monitoring control condition prior to commencing standard CPT.
• Multilevel modeling and an intervening variable approach were utilized to analyze changes in sleep, PTSD, and depression.

Main Results:

• The hypnosis group showed significantly greater improvements in sleep and depression compared to the control group after the initial phase, but not in PTSD.
• Following CPT, both groups improved in sleep and PTSD, with the hypnosis group showing greater reduction in depressive symptoms.
• Improvements in sleep were correlated with improvements in PTSD and depression, with a particularly strong association between sleep and PTSD.

Conclusions:

• Sleep-directed hypnosis is effective in alleviating sleep impairment in individuals with PTSD.
• While hypnosis improves sleep, these sleep gains did not significantly augment the therapeutic gains in PTSD symptom reduction during CPT.
• Further research may be needed to explore mechanisms by which sleep improvements could more effectively enhance PTSD recovery.