Development and Preliminary Evaluation of a Brief Behavioral Sleep Intervention for Veterans to Reduce Nocturnal Vigilance

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Sleep disturbances are common among previously deployed Veterans. Cognitive behavioral therapy for insomnia (CBT-I) has shown promise for Veterans but may not optimally target nocturnal vigilance. The objective of our study was to develop and conducted a pilot evaluation of a brief behavioral intervention that included cognitive exercises intended to reduce the impact of vigilant thoughts and behaviors on sleep. Participants were 40 Veterans who had been deployed to combat zones or hazardous duty areas with mean age 40, and the majority were male, African American, and screened positively for PTSD. Participants were assigned to the study intervention or an educational control at a 2:1 ratio. Participants were assessed at baseline and 1-week after the intervention and those who received the study intervention were re-assessed 3-months later. Improved sleep efficiency, ratings of “feeling rested,” and reduced insomnia severity were seen in the post-treatment week but did not differ between groups. At 3-months, improvements were sustained in the 14 retained participants of the study-intervention, They continued to engage in vigilance reducing exercises. There was further improvement in “feeling rested.” Brief interventions and cognitive exercises to reduce vigilance warrant further evaluation for deployment-related insomnia.

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