@article{1b2c0ecc6dce4352868ba8e65290241a,
title = "Sleep problems in active duty military personnel seeking treatment for posttraumatic stress disorder: Presence, change, and impact on outcomes",
abstract = "Study Objectives: To examine sleep disorder symptom reports at baseline and posttreatment in a sample of active duty U.S. Army Soldiers receiving treatment for posttraumatic stress disorder (PTSD). Explore sleep-related predictors of outcomes. Methods: Sleep was evaluated in 128 participants in a parent randomized clinical trial comparing Spaced formats of Prolonged Exposure (PE) or Present Centered Therapy and a Massed format of PE. In the current study, Spaced formats were combined and evaluated separately from Massed. Results: At baseline, the average sleep duration was < 5 h per night on weekdays/workdays and < 6 h per night on weekends/off days. The majority of participants reported clinically significant insomnia, clinically significant nightmares, and probable sleep apnea and approximately half reported excessive daytime sleepiness at baseline. Insomnia and nightmares improved significantly from baseline to posttreatment in all groups, but many patients reported clinically significant insomnia (>70%) and nightmares (>38%) posttreatment. Excessive daytime sleepiness significantly improved only in the Massed group, but 40% continued to report clinically significant levels at posttreatment. Short sleep (Spaced only), clinically significant insomnia and nightmares, excessive daytime sleepiness, and probable sleep apnea (Massed only) at baseline predicted higher PTSD symptoms across treatment course. Short weekends/off days sleep predicted lower PTSD symptom improvement in the Spaced treatments. Conclusions: Various sleep disorder symptoms were high at baseline, were largely unchanged with PTSD treatment, and were related to worse PTSD treatment outcomes. Studies are needed with objective sleep assessments and targeted sleep disorders treatments in PTSD patients.",
keywords = "Insomnia, Military, Nightmares, PTSD, Sleep disorders",
author = "{STRONG STAR Consortium} and Taylor, {Daniel J.} and Pruiksma, {Kristi E.} and Willie Hale and McLean, {Carmen P.} and Zandberg, {Laurie J.} and Lily Brown and Jim Mintz and {Stacey Young-McCaughan}, Young-McCaughan and Peterson, {Alan L.} and Yarvis, {Jeffrey S.} and Dondanville, {Katherine A.} and Litz, {Brett T.} and John Roache and Foa, {Edna B.}",
note = "Funding Information: We would like to acknowledge and thank the following individuals for their compensated roles on the project and care of servicemen and servicewomen enrolled in the study. Helen Knapp, MA, Kristina Chen, BA, Christina Cope, BA, Tabitha Foster, BA, Amanda Hassell, BA, Emily Kitsmiller, BA, Jaimi Maldonado, BS, and Scarlet Walker, BS (The University of Texas Health Science Center at San Antonio [UT Health San Antonio]) supported the study as study coordinators and research assistants. Brooke Fina, MSW, LCSW, Brittany Hall-Clark, PhD, and Edward Wright, PhD (UT Health San Antonio) served as therapists for the study. Elizabeth Hembree, PhD (University of Pennsylvania) supported the study as a therapy supervisor. Lucas Brilliott, MA, Monica Gauna, PhD, Crystal Mendoza, MA, Susan Paschall, MS, Veronica Vargas, LCSW, Tracy Clemens, PsyD, Katherine Dondanville, PsyD, Kristi Pruiksma, PhD, and Charity Wilkinson, PsyD (UT Health San Antonio) supported the study as independent evaluators. Deanne Hargita, MPA, Antoinette Brundige, MA, Susan Deason, BA, and Gary Burk, MA, MBA (UT Health San Antonio) supported the study as part of the STRONG STAR Administrative Core. Ray Aguilar, BS, Kevin Muenzler, BS, and Gilda Green-Nix (UT Health San Antonio) supported the study as part of the STRONG STAR Data and Biostatistics Core. Christopher Harte, PhD, and Nathan Stein, PhD (VA Boston Healthcare System) supported the study as part of the STRONG STAR Assessment Core. Kimberly Del Carmen, PhD, Holly Campbell-Rosen, PhD, and Inna Williams, MS (DoD, Office of Congressionally Directed Medical Research Programs) supported the study as science officer representatives. Julie R. Collins, BA, and Joel Williams, BA, BS (UT Health San Antonio) provided editorial support for the manuscript. Publisher Copyright: {\textcopyright} Sleep Research Society 2020.",
year = "2020",
month = oct,
day = "1",
doi = "10.1093/sleep/zsaa065",
language = "English (US)",
volume = "43",
journal = "Sleep",
issn = "0161-8105",
publisher = "American Academy of Sleep Medicine",
number = "10",
}