Posttraumatic sleep disturbances in veterans: A pilot randomized controlled trial of cognitive behavioral therapy for insomnia and imagery rehearsal therapy.

Autor: Prguda E; Gallipoli Medical Research Foundation, Brisbane, Queensland, Australia.; The University of Queensland, Brisbane, Queensland, Australia., Evans J; Gallipoli Medical Research Foundation, Brisbane, Queensland, Australia., McLeay S; Gallipoli Medical Research Foundation, Brisbane, Queensland, Australia., Romaniuk M; Gallipoli Medical Research Foundation, Brisbane, Queensland, Australia.; The University of Queensland, Brisbane, Queensland, Australia., Phelps AJ; Department of Psychiatry, Phoenix Australia-Centre for Posttraumatic Mental Health, University of Melbourne, Carlton, Victoria, Australia., Lewis K; Gallipoli Medical Research Foundation, Brisbane, Queensland, Australia., Brown K; Gallipoli Medical Research Foundation, Brisbane, Queensland, Australia.; The University of Queensland, Brisbane, Queensland, Australia., Fisher G; Gallipoli Medical Research Foundation, Brisbane, Queensland, Australia.; The University of Queensland, Brisbane, Queensland, Australia., Lowrie F; Sleep Care, Greenslopes Private Hospital, Brisbane, Queensland, Australia., Saunders-Dow E; Gallipoli Medical Research Foundation, Brisbane, Queensland, Australia., Dwyer M; Gallipoli Medical Research Foundation, Brisbane, Queensland, Australia.; The University of Queensland, Brisbane, Queensland, Australia.
Jazyk: angličtina
Zdroj: Journal of clinical psychology [J Clin Psychol] 2023 Nov; Vol. 79 (11), pp. 2493-2514. Date of Electronic Publication: 2023 Jul 01.
DOI: 10.1002/jclp.23561
Abstrakt: Objectives: Posttraumatic stress disorder (PTSD) is associated with sleep disturbances including insomnia and nightmares. This study compared cognitive behavioral therapy for insomnia (CBT-I) with CBT-I combined with imagery rehearsal therapy (IRT) for nightmares to evaluate if the combined treatment led to greater reductions in trauma-related sleep disturbances in Australian veterans.
Methods: Veterans with diagnosed PTSD, high insomnia symptom severity, and nightmares (N = 31) were randomized to eight group CBT-I sessions or eight group CBT-I + IRT sessions. Self-reported sleep, nightmare, and psychological measures (primary outcome: Pittsburgh Sleep Quality Index), and objective actigraphy data were collected; the effect of obstructive sleep apnea (OSA) risk on treatment outcomes was also examined.
Results: No treatment condition effects were detected for the combined treatment compared to CBT-I alone, and no moderating effect of OSA risk was detected. On average, participants from both groups improved on various self-report measures over time (baseline to 3 months posttreatment). Despite the improvements, mean scores for sleep-specific measures remained indicative of poor sleep quality. There were also no significant differences between the groups on the actigraphy indices.
Conclusions: The findings indicate that there is potential to optimize both treatments for veterans with trauma-related sleep disturbances.
(© 2023 The Authors. Journal of Clinical Psychology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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