Clinical effectiveness of a group therapy combining cognitive behavioural therapy for insomnia and imagery rehearsal therapy for nightmares in an operational stress injury clinic.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Clinical effectiveness of a group therapy combining cognitive behavioural therapy for insomnia and imagery rehearsal therapy for nightmares in an operational stress injury clinic.
Συγγραφείς: Dion K; Sleep Research Unit, University of Ottawa's Institute of Mental Health Research at the Royal, Ottawa, K1Z 7K4, Canada; School of Psychology, University of Ottawa, Ottawa, K1N 6N5, Canada. Electronic address: kdion066@uottawa.ca., Nixon A; School of Psychology, University of Ottawa, Ottawa, K1N 6N5, Canada. Electronic address: anixon@uottawa.ca., Robillard R; Sleep Research Unit, University of Ottawa's Institute of Mental Health Research at the Royal, Ottawa, K1Z 7K4, Canada; School of Psychology, University of Ottawa, Ottawa, K1N 6N5, Canada. Electronic address: Rebecca.Robillard@uottawa.ca., Downs N; Operational Stress Injury Clinic, The Royal Ottawa Mental Health Centre, Ottawa, K1Z 7K4, Canada. Electronic address: ndowns@theroyal.ca., Germain A; School of Medicine, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, United States; NOCTEM Health Inc., Pittsburgh, PA, 15213-4064, United States. Electronic address: anne@noctemhealth.com., Gosselin A; Secure Treatment Unit, Brockville Mental Health Centre, 1831 Oxford Ave, Brockville, ON, K6V 5W7, Canada. Electronic address: anik.gosselin@theroyal.ca., Shlik J; Operational Stress Injury Clinic, The Royal Ottawa Mental Health Centre, Ottawa, K1Z 7K4, Canada. Electronic address: jakov.shlik@theroyal.ca.
Πηγή: Behaviour research and therapy [Behav Res Ther] 2026 Aug; Vol. 203, pp. 105076. Date of Electronic Publication: 2026 May 13.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Science Country of Publication: England NLM ID: 0372477 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-622X (Electronic) Linking ISSN: 00057967 NLM ISO Abbreviation: Behav Res Ther Subsets: MEDLINE
Imprint Name(s): Publication: Oxford : Elsevier Science
Original Publication: Oxford [etc.]
Ιατρικοί όροι (MeSH): Sleep Initiation and Maintenance Disorders*/therapy , Sleep Initiation and Maintenance Disorders*/complications , Sleep Initiation and Maintenance Disorders*/psychology , Dreams*/psychology , Cognitive Behavioral Therapy*/methods , Imagery, Psychotherapy*/methods , Stress Disorders, Post-Traumatic*/therapy , Stress Disorders, Post-Traumatic*/complications , Stress Disorders, Post-Traumatic*/psychology , Psychotherapy, Group*/methods, Military Personnel/psychology ; Humans ; Male ; Middle Aged ; Female ; Adult ; Treatment Outcome ; Personal Satisfaction ; Severity of Illness Index
Περίληψη: Study Objectives: This study evaluated the effectiveness of a group intervention combining cognitive behavioural therapy for insomnia (CBT-I) and imagery rehearsal therapy (IRT) for nightmares, delivered to current and former military and law-enforcement personnel with post-traumatic stress disorder (PTSD) at an outpatient operational stress injury clinic. This study further investigated the interrelationships among changes in insomnia, nightmares and PTSD symptoms during treatment.
Methods: Sixty outpatients (78% male, 50.7 ± 7.3 years) attended 10 weekly 2-h sessions of CBT-I/IRT and completed daily sleep diaries as well as pre-/post-intervention questionnaires assessing the severity of insomnia, nightmares, and PTSD, sleep-related beliefs, ruminations, and life satisfaction.
Results: From baseline to post-intervention, significant reductions were observed in insomnia severity, nightmare distress and frequency, PTSD severity, dysfunctional beliefs about sleep, and insomnia-related ruminations, while life satisfaction increased (all p < .05). Sleep-diary indices improved following CBT-I/IRT, including shorter sleep onset latency (t(37) = 5.0, p = ≤.001), longer total sleep time (t(37) = -1.7, p = .049), less wake after sleep onset (t(37) = 1.8, p = .037), and higher sleep efficiency (t(37) = -5.1, p ≤ .001). A positive correlation was identified between the degree of improvements in insomnia severity and nightmare distress (r(46) = .41, p = .004). Improvements in insomnia severity (r(48) = .35, p = .013) and in nightmare distress (r(46) = .36, p = .012) both correlated with improvements in PTSD.
Conclusions: This study supports the real-world effectiveness of CBT-I/IRT for addressing sleep disturbances, trauma-related symptoms, sleep-related cognitions and life satisfaction in people with PTSD. The multidimensional symptom improvements highlight the value of jointly addressing insomnia and nightmares in trauma-exposed populations and support wider implementation of CBT-I/IRT among service members.
(Copyright © 2026. Published by Elsevier Ltd.)
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Contributed Indexing: Keywords: Cognitive-behavioural therapy for insomnia; Imagery rehearsal therapy; Insomnia; Multimodal therapy; Nightmares; Operational stress injury; Post-traumatic stress disorder
Entry Date(s): Date Created: 20260519 Date Completed: 20260707 Latest Revision: 20260707
Update Code: 20260707
DOI: 10.1016/j.brat.2026.105076
PMID: 42155365
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1873-622X
DOI:10.1016/j.brat.2026.105076