4.4 Review

Recent Advancements in Treating Sleep Disorders in Co-Occurring PTSD

Journal

CURRENT PSYCHIATRY REPORTS
Volume 20, Issue 7, Pages -

Publisher

SPRINGER
DOI: 10.1007/s11920-018-0916-9

Keywords

PTSD; Sleep disorders; Insomnia; Obstructive sleep apnea; Treatment

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Funding

  1. VA RRD CDA Grant [1lK2Rx002120-01]
  2. Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, Department of Veterans Affairs

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Purpose of Review Comorbidity of posttraumatic stress disorder (PTSD) and insomnia, nightmares, and obstructive sleep apnea (OSA) is high. We review recent research on psychotherapeutic and pharmacological interventions for sleep disorders in PTSD. Recent Findings PTSD treatments decrease PTSD severity and nightmare frequency, but do not resolve OSA or insomnia. Research on whether insomnia hinders PTSD treatment shows mixed results; untreated OSA does interfere with PTSD treatment. Cognitive behavioral therapy for insomnia is the recommended treatment for insomnia; however, optimal ordering with PTSD treatment is unclear. PTSD treatment may be most useful for PTSD-related nightmares. CPAP therapy is recommended for OSA but adherence can be low. Summary Targeted treatment of sleep disorders in the context of PTSD offers a unique and underutilized opportunity to advance clinical care and research. Research is needed to create screening protocols, determine optimal order of treatment, and elucidate mechanisms between sleep and PTSD treatments.

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