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ViewAttendees 2

Symposia

Sleep / Wake Disorders

Session: Far-Reaching Impact for Well-Being: Development and Evaluation of Sleep Treatments

2 - (SYM 36) Treatment of Comorbid Sleep Disorders and Posttraumatic Stress Disorder in U.S. Active Duty Military Personnel: A Pilot Randomized Clinical Trial

Friday, November 17, 2023
2:30 PM – 4:00 PM PST
Location: Chiliwack (402), Level 4
Insomnia and nightmares are common in patients with posttraumatic stress disorder (PTSD). They are associated with worse psychological and physical health and with worse PTSD treatment outcomes. They also are resistant to PTSD treatments, which do not typically address sleep disorders. Cognitive Behavioral Therapy for Insomnia and Nightmares (CBT-I&N) and Cognitive Processing Therapy (CPT) for PTSD are first-line treatments, but limited evidence exists guiding the treatment of individuals with all three disorders. The current study randomized U.S. military personnel (N = 93) to CBT-I&N before CPT, CBT-I&N after CPT, or CPT alone; all groups received the same number (18) of sessions. All groups had significantly improved PTSD symptoms. Because the study was terminated prematurely due to challenges with recruitment and retention, the current study was underpowered to answer the research questions posed by the study design. Nonetheless, statistical findings and relevant clinically meaningful changes are reported. Compared to CPT alone, the groups who received CBT-I&N and CPT (regardless of sequencing) had greater improvements on PTSD (d = -.36), insomnia (d = -.77), sleep efficiency (d = .62), and nightmares (d = -.53). Compared to CBT-I&N before CPT, CBT-I&N after CPT had greater improvements on PTSD (d =.48) and sleep efficiency (d = -.44). This pilot study suggests that, compared to treating PTSD alone, treating comorbid insomnia, nightmares, and PTSD results in clinically meaningful advantages in improving PTSD, insomnia and nightmare symptoms.