What interventions are successful in the treatment of sleep disturbances in veterans with PTSD? : an integrative literature review

Abstract

Posttraumatic stress disorder (PTSD) is the most common mental disorder associated with military combat and is a significant health risk for military veterans (Nayback, 2009). The sleep disturbances associated with PTSD are some of the most disabling and difficult to treat aspects of the disorder (Nayback, 2009). The nightmares experienced by veterans are often resistant to typical psychological and pharmacological interventions and require a specifically tailored treatment to improve sleep (Nappi, Drummond, Thorp, & McQuaid, 2009). Interventions for sleep disturbances have not been widely studied in populations with PTSD (Swanson, Favorite, Horin, & Arnedt, 2009).The purpose of this integrative literature review was to gain knowledge of successful interventions for sleep disturbances in veterans with PTSD. Current literature was reviewed and analyzed to increase knowledge of the interventions available for improving sleep in this population. A total of seven articles met inclusion criteria and were utilized in the literature review. Articles were located by searching electronic databases and by hand searching abstracts and reference lists. A constant comparison method was utilized in which data were extracted from the research articles and then compiled into systematic categories (Whittemore & Knafl, 2005). The data were assembled into a large matrix allowing for the comparison of each research study (Whittemore & Knafl, 2005). When performing this literature review, it became evident that there are few interventions available to treat sleep in veterans with PTSD. There did not appear to be a single intervention that was most effective in treating sleep in veterans with PTSD. This review did find literature suggesting that Cognitive Behavioral Therapy (CBT), Imagery Rehearsal Therapy (IRT), and prazosin have all shown varying degrees of effectiveness in the treatment of sleep disturbances in veterans with PTSD. This review of literature suggests it may be beneficial for future research to focus on a combined approach of CBT, IBT, IRT, and prazosin.