Abstract:
Estimates of insomnia prevalence among people with Posttraumatic Stress Disorder (PTSD) range from 40% to 87%. Initial research findings suggest that PTSD treatments, without targeted insomnia interventions, do not appear to address sleep disruption sufficiently. Cognitive behavioral therapy for insomnia (CBT-I) has shown promising effectiveness in PTSD populations. The current study evaluated CBT-I with a brief group treatment approach, which is consistent with the model of care most commonly implemented by Veterans Affairs (VA) Medical Centers. Participants were veterans with trauma-related disorders recruited from two VA Medical Centers. Random assignment was used to divide participants between a CBT-I group and a treatment-as-usual waitlist control group. Participants in the CBT-I group received four 60-minute weekly group sessions. The CBT-I treatment included stimulus control, sleep hygiene instructions, passive muscle relaxation, and sleep education. Validated measures of sleep and daytime functioning were used to evaluate treatment effects. Data from 65 participants were evaluated using mixed design repeated measures analyses. The results showed that participants who received the CBT-I intervention had greater improvements in sleep efficiency as measured by a sleep diary than participants in the waitlist control group. Sleep questionnaire data and daytime functioning outcomes did not differ significantly between the treatment and waitlist groups. Problems related to participant attrition and missing data were limitations in this study. Implications for future research and clinical implementation of insomnia treatment with veterans are discussed.
