Treating Insomnia & Nightmares After Trauma: Impact on Symptoms & Quality of Life

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-01-31

Study Completion Date

2012-11-30

Brief Summary

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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.

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Detailed Description

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Conditions

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Nightmares Insomnia Posttraumatic Stress Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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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

Group Type EXPERIMENTAL

PTSD + IRT/CBT-I

Intervention Type BEHAVIORAL

6 weeks of prolonged exposure, 5 weeks of imagery rehearsal therapy, and 7 weeks of cognitive behavioral therapy for insomnia

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.

Group Type EXPERIMENTAL

PTSD + IRT/CBT-I

Intervention Type BEHAVIORAL

6 weeks of prolonged exposure, 5 weeks of imagery rehearsal therapy, and 7 weeks of cognitive behavioral therapy for insomnia

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.

Group Type EXPERIMENTAL

PTSD + IRT/CBT-I

Intervention Type BEHAVIORAL

6 weeks of prolonged exposure, 5 weeks of imagery rehearsal therapy, and 7 weeks of cognitive behavioral therapy for insomnia

PTSD + Supportive Care Therapy

Intervention Type BEHAVIORAL

6 weeks of prolonged exposure + 12 weeks of supportive care therapy

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.

Group Type ACTIVE_COMPARATOR

PTSD + Supportive Care Therapy

Intervention Type BEHAVIORAL

6 weeks of prolonged exposure + 12 weeks of supportive care therapy

Interventions

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PTSD + IRT/CBT-I

6 weeks of prolonged exposure, 5 weeks of imagery rehearsal therapy, and 7 weeks of cognitive behavioral therapy for insomnia

Intervention Type BEHAVIORAL

PTSD + Supportive Care Therapy

6 weeks of prolonged exposure + 12 weeks of supportive care therapy

Intervention Type BEHAVIORAL

Other Intervention Names

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IRT PE exposure therapy Cognitive Behavioral Therapy for Insomnia PE exposure therapy

Eligibility Criteria

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Inclusion Criteria

* 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

Exclusion Criteria

* 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)

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No