Treating Insomnia & Nightmares After Trauma: Impact on Symptoms & Quality of Life
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 45
- 试验地点
- 1
- 主要终点
- nightmares and insomnia symptoms
研究概览
简要总结
Exposure to trauma, especially when it manifests as Posttraumatic Stress Disorder (PTSD), results in numerous negative consequences for patients, families, and society. Some of the most frequent, disturbing, and treatment resistant symptoms of PTSD are nightmares and insomnia. This study will examine whether treatments specifically targeted at those sleep disorders can improve clinical outcomes and increase health-related quality of life in individuals recently exposed to war-related trauma. Hypotheses are that treating nightmares and insomnia will improve both nighttime and daytime symptoms of PTSD, as well as quality of life.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •1 or more deployments to OEF or OIF
- •Exposure to Trauma
- •Nightmares 2 or more times per week
- •Insomnia for 1 month or more
- •Live in greater San Diego County region
排除标准
- •Use of medications for sleep or nightmares in the past 2 weeks
- •Current enrollment in psychotherapy for PTSD
- •Current or recent substance or alcohol abuse or dependence
- •Other untreated sleep disorders (e.g., sleep apnea)
研究组 & 干预措施
CBT for Insomnia
Patients change their sleep times and habits in order to reduce alertness and "over thinking" when they are trying to sleep. This helps them learn how to sleep overnight in one solid block of time
干预措施: PTSD + IRT/CBT-I (Behavioral)
Imagery Rehearsal Therapy
Patients "rescript" the narrative of a nightmare to eliminate the distressing elements and create a new pleasant dream scene. They then rehearse this scene in their imagination at least twice each day. This reduces the frequency and intensity of the target nightmare and often reduces other nightmares, too.
干预措施: PTSD + IRT/CBT-I (Behavioral)
Prolonged Exposure
This behavioral treatment for PTSD involves 1) systematic and repeated exposure to objects and situations that are avoided due to trauma-related distress, 2) prolonged, repeated recounting of trauma memories through visualization, and 3)therapist-guided discussions of thoughts and emotions related to the exposure exercises. The goals of PE are to reduce the anxiety and distress elicited by trauma-related memories and situations, show patients these memories and situations are distinct from the trauma, and teach patients they can tolerate the distress caused by these memories and situations.
干预措施: PTSD + IRT/CBT-I (Behavioral)
Prolonged Exposure
This behavioral treatment for PTSD involves 1) systematic and repeated exposure to objects and situations that are avoided due to trauma-related distress, 2) prolonged, repeated recounting of trauma memories through visualization, and 3)therapist-guided discussions of thoughts and emotions related to the exposure exercises. The goals of PE are to reduce the anxiety and distress elicited by trauma-related memories and situations, show patients these memories and situations are distinct from the trauma, and teach patients they can tolerate the distress caused by these memories and situations.
干预措施: PTSD + Supportive Care Therapy (Behavioral)
Suportive Care Therapy
This is an active therapy where the focus of the intervention is on helping patients better understand their emotional response to their PTSD and sleep symptoms.
干预措施: PTSD + Supportive Care Therapy (Behavioral)
结局指标
主要结局
nightmares and insomnia symptoms
时间窗: pre-treatment; weeks 6, 11, and 18 of treatment; 3-month follow-up post-treatment
次要结局
- daytime (non-sleep) PTSD symptoms(pre-treatment; weeks 6, 11, and 18 of treatment; 3-month follow-up post-treatment)
- health-related quality of life(pre-treatment; weeks 6, 11, and 18 of treatment; 3-month follow-up post-treatment)
研究者
Sean P.A. Drummond
Associate Professor
University of California, San Diego