0677 Impact of Cognitive Behavioral Therapy for Post-trauma Nightmares on Sleep-efficiency: Examining Data on Sleep Diary Data

Abstract

Abstract Introduction Prior research has not examined the impact of cognitive behavioral therapy (CBT) for post-trauma nightmares on aspects of sleep quality as measured by sleep diary data. While self-report measures assessing sleep quality have demonstrated that CBT for post-trauma nightmares is associated with significant improvements in sleep quality pre- to post-treatment, it is important to specifically analyze changes using sleep diary data given that research has demonstrated large discrepancies in self-report measures of sleep behavior and prospective sleep diary data. Methods All participants in this study were recruited from the local community as part of ongoing clinical trials studying the efficacy of Exposure, Relaxation, Rescription Therapy (ERRT). Each individual reported a history of a criterion A trauma and at least one nightmare weekly. Sleep diary data was collected at each weekly treatment session and included questions regarding time in bed, sleep-onset latency, time out of bed, wake time after sleep onset so that variables of total sleep time, time in bed, and sleep efficiency could be calculated. Participants were instructed to complete the sleep diary each morning while in treatment. Only participants who completed the full ERRT protocol were included. Results Results from 93 individuals were analyzed with a dependent samples t-test. The mean sleep efficacy prior to treatment was .85 (SD = .14) and after treatment was .92 (SD = .07), resulting in a t-value of 3.00 (p < .01; Cohen’s d = .57; 95% CI .16 -.96). Conclusion Results show that there is a significant and meaningful change in sleep efficiency from pre- to post-treatment of a form of CBT for post-trauma nightmares. Given that ERRT does not directly target time in bed or utilize sleep restriction, this is notable that it is associated with such improvements in sleep directly related to time spent in bed. As some research has suggested that aspects of CBT for insomnia may need to be combined with treatment for nightmares to successfully treat trauma-related sleep disturbances, these results indicate that CBT for nightmares alone may be sufficient. Limitations and future directions will be discussed. Support (If Any)