Cognitive-Behavioral Treatment for PTSD-Related Nightmares in Veterans

Recruiting in Palo Alto (17 mi)

+1 other location

Overseen byKatherine Elizabeth Miller, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: VA Office of Research and Development

No Placebo Group

Trial Summary

What is the purpose of this trial?

Trauma-related nightmares in Veterans are associated with poor clinical outcomes, greater substance use, and increased risk of suicide. In spite of an urgent need to reduce the burden of trauma-related nightmares, the underlying physiological changes associated with them are poorly understood, and there are no clear evidence-based recommendations for their treatment. Limitations of current assessment procedures represent a barrier to improved care. In-laboratory sleep studies rarely capture nightmares, limiting the knowledge about them and their response to treatment. This study addresses these limitations by using extended, in-home sleep monitoring to capture sleep data associated with nightmare reports in Veterans, and assessing how these features are altered throughout a cognitive-behavioral nightmare treatment. Results from this study will increase understanding of trauma-related nightmares, and advance strategies for personalizing symptom management for Veterans.

Research Team

Katherine Elizabeth Miller, PhD

Principal Investigator

Minneapolis VA Health Care System, Minneapolis, MN

Eligibility Criteria

This trial is for Veterans with PTSD or subthreshold PTSD, experiencing frequent trauma-related nightmares, and enrolled in VA care at the Minneapolis VA Health Care System. They must have stable housing, be on steady psychoactive meds for two weeks prior to the study, and not be involved in other PTSD-focused treatments.

Inclusion Criteria

I have trouble sleeping, as shown by my PSQI score of 5 or more.

I have been diagnosed with PTSD or have symptoms close to it.

I have been diagnosed with PTSD or have symptoms close to PTSD.

See 5 more

Exclusion Criteria

Current pregnancy and/or birth of a child within the previous 6 months

You were in the hospital for a mental health issue in the last 2 months.

You are currently thinking about harming yourself or others.

See 6 more

Treatment Details

Interventions

Exposure, Relaxation, and Rescripting Therapy (Behavioral Intervention)
Sleep and Nightmare Management (Behavioral Intervention)

Trial OverviewThe study tests a cognitive-behavioral therapy called Exposure, Relaxation, and Rescripting Therapy (ERRT) aimed at managing sleep disturbances and nightmares. It involves extended in-home sleep monitoring to understand physiological changes during trauma-related nightmares.

Participant Groups

2Treatment groups

Experimental Treatment

Active Control

Group I: Exposure, Relaxation, and Rescripting Therapy (ERRT)Experimental Treatment1 Intervention

Exposure, Relaxation, \& Rescripting Therapy (ERRT) will be conducted once a week for five consecutive weeks for approximately one hour per session. Each treatment session focuses on one of the following topics/skills: psycho-education and investment in treatment, sleep behavior modification, Progressive Muscle Relaxation, diaphragmatic breathing, exposure to the trauma-nightmare, rescription, and treatment maintenance planning.

Group II: Sleep and Nightmare ManagementActive Control1 Intervention

This treatment protocol has amounts of therapist contact, handouts, and homework between sessions equivalent to those in ERRT. The protocol contains psychoeducation about sleep disturbances and trauma-related nightmares, including their distressing nature, chronicity, and impact on sleep and daytime functioning. Additionally, basic sleep behavior modification are presented. No nightmare content or rescripting will be explicitly discussed, and the diaphragmatic breathing techniques will be omitted from this protocol.