Cognitive behavioral therapy‑based treatments for insomnia and nightmares in adults with trauma symptoms: a systematic review

This systematic review summarises RCTs that assess the effectiveness of psychological interventions for sleep disturbances in people with post-traumatic stress disorder.

Post-Traumatic Stress Disorder (PTSD) is one of the most frequently reported psychopathological conditions following trauma. PTSD occurs in people who experience and/or witness, either directly or vicariously traumatic events such as accidents, natural disasters and personal assaults (APA, 2013). Depending on the country of residence and social background, the lifetime prevalence of PTSD ranges from 1.3 to 12.2%, (Karam et al., 2014). PTSD leads to several negative physical, psychological and social sequelae. These include but are not limited to physical pain, gastrointestinal and cardio-respiratory issues, anxiety, depression, premature death, onset of Type 2 diabetes, drug and alcohol use, reduced occupational capacity and loss of important personal relationships (Pacella et al., 2013; Pietrzak et al., 2011; Schlenger et al., 2015; Shalev et al., 2017; Vogt et al., 2016).

Insomnia and nightmares are the most prevalent sleep disturbances reported by people with PTSD (Buysse et al., 2006; Pruiksma et al., 2016). Studies show that 70% to 91% of people with PTSD have difficulty initiating sleep, staying asleep, and may experience chronic nightmares (Neylan et al., 1998; Ohayon & Shapiro, 2000). Notably, insomnia and nightmares are the most frequently reported residual health problems following a successful resolution of PTSD treatment with psychological interventions (Pruiksma et al., 2016).