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Efficacy of a cognitive-behavioral treatment for insomnia and nightmares in Afghanistan and Iraq veterans with PTSD.
J Clin Psychol. 2013 Oct; 69(10):1026-42.JC

Abstract

OBJECTIVE

Sleep disturbances are a core and salient feature of posttraumatic stress disorder (PTSD). Pilot studies have indicated that combined cognitive-behavioral therapy for insomnia (CBT-I) and imagery rehearsal therapy (IRT) for nightmares improves sleep as well as PTSD symptoms.

METHOD

The present study randomized 40 combat veterans (mean age 37.7 years; 90% male and 60% African American) who served in Afghanistan and/or Iraq (Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]) to 4 sessions of CBT-I with adjunctive IRT or a waitlist control group. Two thirds of participants had nightmares at least once per week and received the optional IRT module.

RESULTS

At posttreatment, veterans who participated in CBT-I/IRT reported improved subjectively and objectively measured sleep, a reduction in PTSD symptom severity and PTSD-related nighttime symptoms, and a reduction in depression and distressed mood compared to the waitlist control group.

CONCLUSION

The findings from this first controlled study with OEF/OIF veterans suggest that CBT-I combined with adjunctive IRT may hold promise for reducing both insomnia and PTSD symptoms. Given the fact that only half of the patients with nightmares fully implemented the brief IRT protocol, future studies should determine if this supplement adds differential efficacy to CBT-I alone.

Authors+Show Affiliations

Eastern Virginia Medical School.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

23629959

Citation

Margolies, Skye Ochsner, et al. "Efficacy of a Cognitive-behavioral Treatment for Insomnia and Nightmares in Afghanistan and Iraq Veterans With PTSD." Journal of Clinical Psychology, vol. 69, no. 10, 2013, pp. 1026-42.
Margolies SO, Rybarczyk B, Vrana SR, et al. Efficacy of a cognitive-behavioral treatment for insomnia and nightmares in Afghanistan and Iraq veterans with PTSD. J Clin Psychol. 2013;69(10):1026-42.
Margolies, S. O., Rybarczyk, B., Vrana, S. R., Leszczyszyn, D. J., & Lynch, J. (2013). Efficacy of a cognitive-behavioral treatment for insomnia and nightmares in Afghanistan and Iraq veterans with PTSD. Journal of Clinical Psychology, 69(10), 1026-42. https://doi.org/10.1002/jclp.21970
Margolies SO, et al. Efficacy of a Cognitive-behavioral Treatment for Insomnia and Nightmares in Afghanistan and Iraq Veterans With PTSD. J Clin Psychol. 2013;69(10):1026-42. PubMed PMID: 23629959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of a cognitive-behavioral treatment for insomnia and nightmares in Afghanistan and Iraq veterans with PTSD. AU - Margolies,Skye Ochsner, AU - Rybarczyk,Bruce, AU - Vrana,Scott R, AU - Leszczyszyn,David J, AU - Lynch,John, Y1 - 2013/04/29/ PY - 2013/5/1/entrez PY - 2013/5/1/pubmed PY - 2014/4/24/medline KW - PTSD KW - cognitive-behavior therapy for insomnia KW - imagery rehearsal therapy KW - insomnia KW - nightmares SP - 1026 EP - 42 JF - Journal of clinical psychology JO - J Clin Psychol VL - 69 IS - 10 N2 - OBJECTIVE: Sleep disturbances are a core and salient feature of posttraumatic stress disorder (PTSD). Pilot studies have indicated that combined cognitive-behavioral therapy for insomnia (CBT-I) and imagery rehearsal therapy (IRT) for nightmares improves sleep as well as PTSD symptoms. METHOD: The present study randomized 40 combat veterans (mean age 37.7 years; 90% male and 60% African American) who served in Afghanistan and/or Iraq (Operation Enduring Freedom [OEF]/Operation Iraqi Freedom [OIF]) to 4 sessions of CBT-I with adjunctive IRT or a waitlist control group. Two thirds of participants had nightmares at least once per week and received the optional IRT module. RESULTS: At posttreatment, veterans who participated in CBT-I/IRT reported improved subjectively and objectively measured sleep, a reduction in PTSD symptom severity and PTSD-related nighttime symptoms, and a reduction in depression and distressed mood compared to the waitlist control group. CONCLUSION: The findings from this first controlled study with OEF/OIF veterans suggest that CBT-I combined with adjunctive IRT may hold promise for reducing both insomnia and PTSD symptoms. Given the fact that only half of the patients with nightmares fully implemented the brief IRT protocol, future studies should determine if this supplement adds differential efficacy to CBT-I alone. SN - 1097-4679 UR - https://www.unboundmedicine.com/medline/citation/23629959/Efficacy_of_a_cognitive_behavioral_treatment_for_insomnia_and_nightmares_in_Afghanistan_and_Iraq_veterans_with_PTSD_ L2 - https://doi.org/10.1002/jclp.21970 DB - PRIME DP - Unbound Medicine ER -