Journal
BEHAVIOUR RESEARCH AND THERAPY
Volume 143, Issue -, Pages -Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.brat.2021.103892
Keywords
Sleep; PTSD; TBI; Treatment; Cognitive symptoms; Neuropsychology
Categories
Funding
- Department of Defense [W81XWH1110641]
- VA Rehabilitation Research & Development (RR&D) Service Career Development Awards [IK2 RX002459, IK2 RX00151201A2]
- VA RRD MERIT [1 I01 RX001691]
- U.S. Department of Defense (DOD) [W81XWH1110641] Funding Source: U.S. Department of Defense (DOD)
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Poor sleep quality is common among Veterans with posttraumatic stress disorder (PTSD) and history of traumatic brain injury (TBI). However, the study found that trauma-focused treatment did not lead to improvement in sleep quality, and baseline poor sleep quality was associated with less improvement in PTSD symptoms and cognitive complaints.
Poor sleep quality is common among Veterans with posttraumatic stress disorder (PTSD) and history of traumatic brain injury (TBI). However, the relationship between sleep quality and treatment outcomes following traumafocused interventions is less well-understood in this population. We sought to better understand whether 1) sleep quality changed as a result of trauma-focused treatment and 2) if baseline sleep quality moderated psychological and neurobehavioral treatment outcomes. Our sample consisted of 100 Iraq/Afghanistan era Veterans with PTSD and history of mild to moderate TBI who were randomized to one of two trauma-focused treatments: 1) Cognitive Processing Therapy (CPT) or 2) combined CPT and Cognitive Symptom Management and Rehabilitation Therapy (SMART-CPT). Self-reported sleep quality, psychiatric symptoms (PTSD and depression), and neurobehavioral concerns were assessed at multiple timepoints throughout the study. Multilevel modeling showed sleep quality did not improve, regardless of treatment condition. However, worse baseline sleep quality was associated with less improvement in PTSD symptoms and cognitive complaints. There was no effect of baseline sleep quality on change in depression symptoms. These findings suggest that more targeted treatments to address sleep quality either prior to or in conjunction with trauma-focused therapy may help to improve treatment outcomes for Veterans with comorbid PTSD and TBI history.
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