In a path towards better understanding and improving sleep for veterans, the Gallipoli Medical Research Foundation (GMRF) have published a new qualitative study, which is a follow up to GMRF’s sleep study.

GMRF’s sleep study compared two cognitive behavioural sleep treatments for veterans with trauma-related sleep disturbances, including insomnia and nightmares. This study compared Cognitive Behavioural Therapy for Insomnia (CBT-I) with CBT-I combined with Imagery Rehearsal Therapy (IRT). CBT-I is a leading treatment for insomnia and IRT is a nightmare treatment.

This second follow up qualitative study (interviews and focus group) involved interviewing participants about their own experiences and acceptance of CBT-I and IRT. Researchers conducted individual interviews with veterans who completed either CBT-I or CBT-I + IRT, and a focus group with the facilitators who delivered the treatments.

Overall, the veterans reported positive experiences with both treatments, noting tangible benefits and improvements in their sleep quality.

The findings revealed several key themes:

Acceptability of Treatments: Veterans generally found both CBT-I and IRT to be acceptable and reported experiencing meaningful treatment benefits.

Nightmare Reduction: While CBT-I participants described continuing to experience posttraumatic nightmares, most IRT participants reported benefits that included a reduction in nightmares. It was noted that IRT seemed particularly beneficial for veterans with persistent nightmares that bothered them.

Treatment Engagement and Retention: Factors influencing engagement and retention in the treatments were discussed, highlighting the importance of being open to trying sleep treatments and military informed treatment provision.

Variability in Benefits: Not all veterans perceived equal benefits from IRT, suggesting that individual differences play a role in treatment outcomes.

Recommendations for Future Research: The participants’ recommendations from the study offer valuable insights for clinical applications and future research endeavors.

Some of the recommendations include:

– Digitising the sleep diary (e.g., through a phone app) to make tracking sleep easier.

– Adding a follow-up session to check on each person’s progress.

– Making sure that there is opportunity for engaging group discussions as participants benefited from the group setting.

– Summarise and simplify more technical language and content.

“Although more research is needed to optimise CBT-I and IRT for veterans who experience trauma-related sleep disturbances, this qualitative study has given us insights into how veterans and facilitators perceived the sleep treatments, which helps to inform future delivery improvements and future research” said Dr Emina Prguda, Research Fellow at GMRF.

The GMRF study emphasises that sleep treatments are available and encourages veterans with sleep disturbances to explore CBT-I as a potential option and IRT if nightmares form part of the sleep disturbances. These therapies have the potential to provide a pathway towards better sleep and improved well-being for veterans struggling with sleep disturbances.

The article, Veteran treatment completers’ and facilitators’ perceptions of cognitive behavioral therapy for insomnia and imagery rehearsal therapy for posttraumatic sleep disturbances, was published in the journal Dreaming in December 2023 (Advance online publication).

Read the article here: