OBJECTIVE: Approximately 35-61% of individuals with posttraumatic stress disorder (PTSD) report insomnia. Further, upward of 70% report clinically significant insomnia following PTSD treatment. There are converging lines of evidence suggesting that insomnia not only independently affects daytime functioning and worsens PTSD symptoms but also may compromise response to PTSD treatment, such as prolonged exposure (PE). Taken together, integrated insomnia and PTSD treatment may increase client-centered care and treatment outcomes. METHOD: This article reviews the theory and evidence for treating sleep prior to PTSD treatment, describes the key elements of integrated cognitive-behavioral treatment for insomnia (CBT-I) and PE (2NITE protocol), and presents pilot data from a sample of 12 treatment-seeking veterans with PTSD and insomnia who completed the 2NITE protocol. Sleep data were collected with sleep diaries and actigraphy watches. RESULTS: The Client Satisfaction Questionnaire indicated high satisfaction with the 2NITE protocol (mean score 29.66 out of 32 points). On average, there were statistical and clinically significant changes in all measures, including a 20.17-point decrease in the PTSD Checklist DSM-5, a 11.75-point decrease in the insomnia severity index, an 18.58-point increase in the World Health Organization Quality of Life index, a 11% increase in sleep efficiency, and a 51-min increase in total sleep time from the actigraphy data. CONCLUSIONS: Among individuals with insomnia and PTSD, integrating CBT-I and PE with the 2NITE protocol represents a logical, innovative, and empirically informed method for augmenting existing treatments and optimizing outcomes that justifies further investigation. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
OBJECTIVE: Approximately 35-61% of individuals with posttraumatic stress disorder (PTSD) report insomnia. Further, upward of 70% report clinically significant insomnia following PTSD treatment. There are converging lines of evidence suggesting that insomnia not only independently affects daytime functioning and worsens PTSD symptoms but also may compromise response to PTSD treatment, such as prolonged exposure (PE). Taken together, integrated insomnia and PTSD treatment may increase client-centered care and treatment outcomes. METHOD: This article reviews the theory and evidence for treating sleep prior to PTSD treatment, describes the key elements of integrated cognitive-behavioral treatment for insomnia (CBT-I) and PE (2NITE protocol), and presents pilot data from a sample of 12 treatment-seeking veterans with PTSD and insomnia who completed the 2NITE protocol. Sleep data were collected with sleep diaries and actigraphy watches. RESULTS: The Client Satisfaction Questionnaire indicated high satisfaction with the 2NITE protocol (mean score 29.66 out of 32 points). On average, there were statistical and clinically significant changes in all measures, including a 20.17-point decrease in the PTSD Checklist DSM-5, a 11.75-point decrease in the insomnia severity index, an 18.58-point increase in the World Health Organization Quality of Life index, a 11% increase in sleep efficiency, and a 51-min increase in total sleep time from the actigraphy data. CONCLUSIONS: Among individuals with insomnia and PTSD, integrating CBT-I and PE with the 2NITE protocol represents a logical, innovative, and empirically informed method for augmenting existing treatments and optimizing outcomes that justifies further investigation. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Authors: Peter J Colvonen; Tonya Masino; Sean P A Drummond; Ursula S Myers; Abigail C Angkaw; Sonya B Norman Journal: J Clin Sleep Med Date: 2015-04-15 Impact factor: 4.062
Authors: Charles M Morin; Richard R Bootzin; Daniel J Buysse; Jack D Edinger; Colin A Espie; Kenneth L Lichstein Journal: Sleep Date: 2006-11 Impact factor: 5.849
Authors: Anisa J Marshall; Dean T Acheson; Victoria B Risbrough; Laura D Straus; Sean P A Drummond Journal: J Neurosci Date: 2014-08-27 Impact factor: 6.167
Authors: Elizabeth M Walters; Melissa M Jenkins; Carla M Nappi; Jacob Clark; July Lies; Sonya B Norman; Sean P A Drummond Journal: Psychol Trauma Date: 2019-06-27
Authors: Alyson K Zalta; Linzy M Pinkerton; Zerbrina Valdespino-Hayden; Dale L Smith; Helen J Burgess; Philip Held; Randy A Boley; Niranjan S Karnik; Mark H Pollack Journal: J Trauma Stress Date: 2020-03-26
Authors: Ateka A Contractor; Danica C Slavish; Nicole H Weiss; Ahmad M Alghraibeh; Ali A Alafnan; Daniel J Taylor Journal: J Clin Psychol Date: 2021-04-19
Authors: Peter J Colvonen; Erin Almklov; Jessica C Tripp; Christi S Ulmer; James O E Pittman; Niloofar Afari Journal: Sleep Date: 2020-12-14 Impact factor: 5.849
Authors: Quinn M Biggs; Robert J Ursano; Jing Wang; Gary H Wynn; Russell B Carr; Carol S Fullerton Journal: BMC Psychiatry Date: 2020-04-16 Impact factor: 3.630