Academic Journal
Clinical effectiveness of a group therapy combining cognitive behavioural therapy for insomnia and imagery rehearsal therapy for nightmares in an operational stress injury clinic.
| 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. |
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| 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 |
| ISSN: | 1873-622X |
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| DOI: | 10.1016/j.brat.2026.105076 |