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 For the new analysis, published online in Sleep, researchers
recruited 151 active-duty U.S. Army personnel stationed at Fort
Hood, Texas who had chronic insomnia and randomly assigned half of
them to receive six weekly 60-minute sessions of a treatment
cognitive behavior therapy for insomnia (CBTi).
All the soldiers had served at least one military deployment in or
around Iraq or Afghanistan. The average age was about 32, and more
than 80 percent were male.
CBTi is a short-term, goal oriented type of psychotherapy that tries
to change destructive thinking and behavior. It has been
successfully used since the 1960s in civilian populations to treat
several clinical problems besides insomnia.
The soldiers' CBTi program also included relaxation training and
helpful tips on how to get a good night's sleep, or sleep hygiene,
such as avoiding activities in bed like using a computer, eating or
watching TV.
Control group volunteers were contacted briefly every other week for
six weeks.
About 11 weeks after the start of the study, participants receiving
CBTi were sleeping longer and waking less during the night than
control subjects.
CBTi also helped military personnel reduce their mental fatigue and
improve their scores on assessments of their mental health.
Lead author Daniel J. Taylor of the University of North Texas in
Denton told Reuters Health by phone that up to 20 percent of active
military personnel have insomnia.
"If you want to keep your fighting forces as healthy as possible,
you want to address modifiable risk factors like sleep as early and
effectively as possible. We know that people with insomnia have
comorbid depression, anxiety and PTSD. It’s possible that insomnia
may exacerbate these conditions," he said.
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Based on the results, Taylor believes, "CBTi should be the first
line treatment of insomnia in active duty military."
Michael Twery, director of the National Heart, Lung and Blood
Institute's National Center on Sleep Disorders Research in Bethesda,
Maryland, cautioned, however, that "while CBT is an evidenced-based
therapy and has efficacy in the general population, it doesn’t work
for everyone."
He told Reuters Health by phone that people who feel they're getting
insufficient sleep or who have extensive daytime sleepiness that
interferes with their ability to function during the day for about
two weeks should discuss it with their primary care provider.
"In some cases insomnia can be an indicator of other medical
problems like infection or cancer. Insufficient sleep is also a red
flag for suicide ideation," said Twery, who was not involved in the
research.
Taylor said more studies are needed to determine whether treating
insomnia could reduce depression, substance abuse and PTSD symptoms,
as well as work safety and operational readiness. He also hopes to
test the effect of CBTi in other military settings, including before
and during deployment.
"My hope is that the outcome of this study is that the military
massively trains more people who can provide CBTi for insomnia,"
said Taylor.
SOURCE: http://bit.ly/2r6menp Sleep, online April 5, 2018.
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