Treatments for Insomnia in Veterans With PTSD

Description

This randomized trial will compare a novel treatment, Acceptance of the Behavioral Changes to Treat Insomnia (ABC-I) to Cognitive Behavioral Therapy for Insomnia (CBT-I) among Veterans with comorbid Post-Traumatic Stress Disorder (PTSD) and insomnia disorder. ABC-I combines the behavioral components of CBT-I with components of another behavioral therapy (Acceptance and Commitment Therapy) and has been shown to improve treatment adherence. The study objectives are: 1) to evaluate the benefits of ABC-I in reducing post-traumatic stress disorder (PTSD) symptoms among Veterans with comorbid PTSD and insomnia disorder compared to CBT-I, and 2) to evaluate the effectiveness of ABC-I in improving insomnia symptoms and sleep quality among Veterans with comorbid PTSD and insomnia disorder as compared to CBT-I. Veterans with insomnia and comorbid PTSD who receive care at Sepulveda and West Los Angeles facilities will be recruited for the study. Those who pass an initial eligibility screen will be enrolled and written informed consent will be obtained. A baseline assessment will be completed that includes measures of sleep, PTSD, and quality of life. Veterans who meet all eligibility criteria will be randomly assigned to the ABC-I (n=100) or CBT-I (n=100) treatment. Both treatments will be provided in 5 one-on-one sessions by a trained instructor who is supervised by a behavioral sleep medicine specialist. All randomized participants (n=200) will have 3 follow-up assessments (post-treatment, 3-months, and 6-months after randomization). The follow-up assessments will collect information on PTSD symptoms, insomnia symptoms and sleep quality.

Conditions

Insomnia, PTSD

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Study Overview

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Study Details

Study overview

This randomized trial will compare a novel treatment, Acceptance of the Behavioral Changes to Treat Insomnia (ABC-I) to Cognitive Behavioral Therapy for Insomnia (CBT-I) among Veterans with comorbid Post-Traumatic Stress Disorder (PTSD) and insomnia disorder. ABC-I combines the behavioral components of CBT-I with components of another behavioral therapy (Acceptance and Commitment Therapy) and has been shown to improve treatment adherence. The study objectives are: 1) to evaluate the benefits of ABC-I in reducing post-traumatic stress disorder (PTSD) symptoms among Veterans with comorbid PTSD and insomnia disorder compared to CBT-I, and 2) to evaluate the effectiveness of ABC-I in improving insomnia symptoms and sleep quality among Veterans with comorbid PTSD and insomnia disorder as compared to CBT-I. Veterans with insomnia and comorbid PTSD who receive care at Sepulveda and West Los Angeles facilities will be recruited for the study. Those who pass an initial eligibility screen will be enrolled and written informed consent will be obtained. A baseline assessment will be completed that includes measures of sleep, PTSD, and quality of life. Veterans who meet all eligibility criteria will be randomly assigned to the ABC-I (n=100) or CBT-I (n=100) treatment. Both treatments will be provided in 5 one-on-one sessions by a trained instructor who is supervised by a behavioral sleep medicine specialist. All randomized participants (n=200) will have 3 follow-up assessments (post-treatment, 3-months, and 6-months after randomization). The follow-up assessments will collect information on PTSD symptoms, insomnia symptoms and sleep quality.

A Novel Acceptance-based Treatment for Insomnia in Veterans With Post-Traumatic Stress Disorder

Treatments for Insomnia in Veterans With PTSD

Condition
Insomnia
Intervention / Treatment

-

Contacts and Locations

Sepulveda

VA Greater Los Angeles Healthcare System, Sepulveda, CA, Sepulveda, California, United States, 91343

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * community-dwelling Veterans aged 18 years and older,
  • * received care from VAGLAHS in the prior year,
  • * live within a 50-mile radius of the research offices at the VA Sepulveda Ambulatory Care Center,
  • * have symptoms of PTSD,
  • * have symptoms of insomnia.
  • * current pregnancy or has a child less than 6 months of age (men and women),
  • * active substance users or in recovery with less than 90 days of sobriety,
  • * too ill to engage in the study procedures,
  • * unable to self-consent to participate,
  • * unstable housing (since we may not be able to retrieve costly and difficult to replace monitoring equipment),
  • * severe, untreated sleep disordered breathing (AHI\>15 with excessive daytime sleepiness, or AHI\>30),
  • * restless legs syndrome that accounts for the sleep disturbances reported,
  • * a circadian rhythm sleep disorder that accounts for the sleep disturbances reported (including shift work sleep disorder),
  • * unstable medical or psychiatric disorders (which is a contraindication for behavioral treatment of insomnia);
  • * remission of insomnia symptoms prior to randomization;
  • * current participation in prolonged exposure therapy for PTSD.

Ages Eligible for Study

18 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

VA Office of Research and Development,

Jennifer L Martin, PhD, PRINCIPAL_INVESTIGATOR, VA Greater Los Angeles Healthcare System, Sepulveda, CA

Study Record Dates

2026-06-30