Cognitive Behavioral Therapy for Insomnia With Prolonged Exposure Compared to Sleep Hygiene and Prolonged Exposure

Co-occurrence of posttraumatic stress disorder (PTSD) and insomnia disorder is common and associated with greater psychiatric and functional problems than either condition alone. Evidence-based PTSD treatment often does not effectively decrease insomnia, and insomnia may interfere with the mechanisms underlying PTSD treatment. This study compared the efficacy of integrated cognitive behavioral therapy for insomnia (CBT-I) and prolonged exposure (PE; CBTI-PE) therapy to sleep hygiene and PE (hygiene-PE) in reducing insomnia and PTSD symptoms. ), quality of life (World Health Organization Quality of Life-BREF WHOQOL), and insomnia severity (ISI, subjective sleep efficiency SE, total sleep time TST) between baseline, week 5, posttreatment, and 3-month follow-up. < .001). On average, participants had reductions in PTSD symptoms, with no differences between the groups. CBTI-PE produced greater reductions in insomnia symptoms and larger increases in QOL, SE, and TST than hygiene-PE. Together, CBT-I PE is an effective intervention for treating 2 highly co-occurring disorders, insomnia and PTSD. ClinicalTrials.gov identifier: NCT02774642.