A Randomized, Controlled Trial of a Modified Sleep and Circadian Intervention for Veterans With PTSD: Advancing Psychosocial Rehabilitation Through Sleep Health
VA Office of Research and Development
Summary
Sleep disturbance is a major problem in Veterans with posttraumatic stress disorder (PTSD). This study will test a version of a sleep treatment that's been shown to be effective in the general population, with some changes to tailor it to the needs of Veterans with PTSD and sleep disturbance.
Description
Sleep disturbance in military Veterans with PTSD is a complex condition, typically characterized by insomnia and nightmares, and frequently accompanied by comorbid obstructive sleep apnea. Each of these problems are shown to influence the others, contributing to a complex sleep disturbance with profound impacts on daytime functioning and quality of life. A vicious cycle in which nighttime disturbances impact daytime functioning, and vice versa, often ensues. Addressing sleep disturbance in Veterans with PTSD therefore requires a multipronged approach that is tailored to each Veterans' constell…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * U.S. Military Veteran aged 18 and above engaged in VA primary and/or mental health care * CAPS 5 PTSD diagnosis; or CAPS 5 score \>=25 in the absence of full criteria * SCID Insomnia Disorder diagnosis, supported by ISI score \>=10 * CAPS-IV nightmare score \>=4 * Sleep-related functional impairment based on a WHODAS score \>=32 * Willingness to engage in 8-12 sessions of treatment to address their sleep disturbance Exclusion Criteria: * Current cognitive problems, active psychosis or mania, or other mental/cognitive conditions such as moderate to severe neurodegenerat…
Interventions
- BehavioralTranS-C for PTSD
The Transdiagnostic sleep and circadian intervention (TranS-C), developed by Allison Harvey, Ph.D. and Daniel Buysse, M.D., involves a patient-centered, module-based, flexibly structured approach that tackles numerous sleep disturbances using evidence-based strategies with the goal of improving sleep and related impairments in daytime functioning. It is thus well-suited for tackling sleep disturbances and the associated impairments in social, occupational and overall functioning in veterans with PTSD. The proposed study is a randomized, controlled clinical trial examining the effectiveness of a modified TranS-C intervention for veterans with PTSD. The modified approach, TranS-C for PTSD (TSC-PTSD), elevates the importance of nightmare-focused, apnea-focused, and insomnia-focused modules relative to the standard intervention, incorporates an evidence-based relaxation module, and modifies the nightmare and apnea modules based on strategies used for veterans in the VA healthcare system.
- BehavioralSleep Psychoeducation Control
Participants will receive psychoeducation about sleep.
Location
- San Francisco VA Medical Center, San Francisco, CASan Francisco, California