Differential Associations Between Sleep Domains and Response to Prolonged Exposure Therapy.
David L Yap1,2,3, Brooklynn Bailey2, Hanah B Weldon4
1The Graduate Center, City University of New York, New York, NY 10016, USA.
Behavioral Sciences (Basel, Switzerland)
|December 30, 2025
Summary
Improving overall sleep quality enhances psychotherapy for posttraumatic stress disorder (PTSD). However, increased daytime dysfunction due to sleep issues may hinder long-term PTSD symptom reduction.
Area of Science:
- Psychology
- Psychiatry
- Sleep Medicine
Background:
- Prolonged Exposure (PE) is an effective psychotherapy for posttraumatic stress disorder (PTSD).
- A subset of veterans does not fully benefit from PE.
- Sleep's role in memory consolidation suggests poor sleep may impede PE's effectiveness.
Purpose of the Study:
- To investigate if multidimensional sleep quality changes predict PTSD symptom reduction during and after PE.
- To examine concurrent and prospective associations between sleep domains and PTSD symptoms.
Main Methods:
- Assessed sleep quality using a multidimensional measure pre- and post-treatment.
- Measured PTSD symptoms pre-treatment, post-treatment, and at 3- and 6-month follow-ups.
- Analyzed changes in sleep domains as predictors of PTSD symptom severity.
Main Results:
- Improvements in overall sleep quality, subjective sleep, and daytime function correlated with reduced PTSD symptoms from pre- to post-treatment.
- Enhanced overall sleep quality and daytime function predicted lower PTSD severity at follow-up.
- Increased daytime dysfunction predicted worsening PTSD symptoms over time.
Conclusions:
- Overall sleep quality is crucial for successful PE treatment outcomes.
- Daytime dysfunction resulting from sleep problems may negatively impact long-term PTSD symptom reduction.
- Targeting sleep quality and daytime dysfunction could improve PE efficacy.
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