7857 Cognitive - Behavioral Treatments for PTSD Sleep Disturbance
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Post-traumatic Stress Disorder
- Sponsor
- US Department of Veterans Affairs
- Enrollment
- 134
- Locations
- 1
- Primary Endpoint
- Pittsburgh Sleep Quality Index
- Status
- Completed
- Last Updated
- 11 years ago
Overview
Brief Summary
The purpose of this study is to compare the effectiveness of two cognitive behavioral group psychotherapy interventions in controlling the subjective sleep disturbance in veterans with Post-traumatic Stress Disorder.
Detailed Description
Repetitive, stereotypical nightmares and insomnia commonly characterize post-traumatic stress disorder (PTSD). Identifying the pathophysiological mechanisms of disrupted sleep in PTSD has therefore assumed considerable clinical importance. We previously reported an increase in rapid eye movement activity (REM activity) during REM sleep (REMS) in Vietnam War combat veterans with PTSD, and this finding can be seen as consistent with the view that most, although not all, dreaming occurs during REMS and the repeated observation that REM activity correlates with the intensity of dream mentation. There is a growing body of evidence that post-traumatic nightmares can respond to psychological treatment interventions. Namely, a cognitive-behavioral technique entitled imagery rehearsal (IR) has been reported to be effective in the treatment of such nightmares in victims of crime and in women who have been sexually assaulted. In a small pilot study, it has also been reported to be effective in the treatment of Vietnam veterans with combat-related PTSD. The two objectives of this proposal are: 1. To compare, in a study with random assignment and a parallel group design, the effectiveness in controlling the subjective sleep disturbance in veterans with PTSD of IR and Sleep and Nightmare Management (SN), a psychological treatment that targets life stressors and problems with sleep hygiene that may exacerbate insomnia and nightmares. 2. In a subset of these subjects, to compare the effectiveness in reducing REM activity of IR and SN.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Vietnam Combat Veteran
- •Diagnosis of combat-related PTSD
- •Stable psychotropic regimen for a minimum of three months
- •Experiences recurrent nightmares
Exclusion Criteria
- •Bipolar disorder, delirium, dementia, amnestic and other cognitive disorders
- •Schizophrenia and other psychotic disorders
- •Substance abuse or dependence within the last six months
- •Untreated medical disorders known to impact sleep
Outcomes
Primary Outcomes
Pittsburgh Sleep Quality Index
Time Frame: Baseline and 1, 3, and 6 months post-treatment
Total scores range from 0 to 21, with higher values indicating poorer sleep quality. A score greater than 5 distinguishes between poor and good sleepers.
Weekly Number of Nightmares
Time Frame: Baseline and 1, 3, and 6 months post-treatment
Weekly Nights With a Nightmare
Time Frame: Baseline and 1, 3, and 6 months post-treatment
Secondary Outcomes
- Pittsburgh Sleep Quality Index - Addendum(Baseline and 1, 3, and 6 months post-treatment)
- Nightmare Effects Survey(Baseline and 1, 3, and 6 months post-treatment)
- PTSD Military Checklist(Baseline and 1, 3, and 6 months post-treatment)
- Beck Depression Inventory(Baseline and 1, 3, and 6 months post-treatment)
- SF-36 Physical Component(Baseline and 1, 3, and 6 months post-treatment)
- SF-36 Mental Component(Baseline and 1, 3, and 6 months post-treatment)
- Clinician-Administered PTSD Scale (CAPS)(Baseline and 1 month post-treatment)