Cognitive behavioral therapy for insomnia in veterans with gulf war illness: Results from a randomized controlled trial

LIFE SCIENCES

卷:279

Article

Chao, Linda L.^1,2  Kanady, Jennifer C.³  Crocker, Nicole¹  Straus, Laura D.^1,2,4  Hlavin, Jennifer¹  Metzler, Thomas J.^1,2,4  Maguen, Shira^1,2,4  Neylan, Thomas C.^1,2,4 

[1] San Francisco Vet Affairs Hlth Care Syst, San Francisco, CA 94121 USA

[2] Univ Calif San Francisco, San Francisco, CA 94143 USA

[3] Sleepio, Big Hlth, San Francisco, CA 94108 USA

[4] Sierra Pacific Mental Illness Res Educ & Clin Ctr, San Francisco, CA 94121 USA

关键词: Gulf war illness;    Chronic multisymptom illness;    Insomnia;    Cognitive behavioral therapy;    Telehealth;    Veteran;   

DOI  :  10.1016/j.lfs.2021.119147

来源: Elsevier

【 摘 要 】

Aims: To examine whether cognitive behavioral therapy for insomnia (CBT-I), delivered by telephone, improves sleep and non-sleep symptoms of Gulf War Illness (GWI). Main methods: Eighty-five Gulf War veterans (21 women, mean age: 54 years, range 46-72 years) who met the Kansas GWI case definition, the Centers for Disease Control and Prevention (CDC) case definition for Chronic Multisymptom Illness (CMI), and research diagnostic criteria for insomnia disorder were randomly assigned to CBT-I or monitor-only wait list control. Eight weekly sessions of individual CBT-I were administered via telephone by Ph.D. level psychologists to study participants. Outcome measures included pre-, mid-, and posttreatment assessments of GWI and insomnia symptoms, subjective sleep quality, and continuous sleep monitoring with diary. Outcomes were re-assessed 6-months post-treatment in participants randomized to CBT-I. Key findings: Compared to wait list, CBT-I produced significant improvements in overall GWI symptom severity, individual measures of fatigue, cognitive dysfunction, depression and anxiety, insomnia severity, subjective sleep quality, and sleep diary outcome measures. The beneficial effects of CBT-I on overall GWI symptom severity and most individual GWI symptom measures were maintained 6-months after treatment. Significance: GWI symptoms have historically been difficult to treat. Because CBT-I, which is associated with low stigma and is increasingly readily available to veterans, improved both sleep and non-sleep symptoms of GWI, these results suggest that a comprehensive approach to the treatment of GWI should include behavioral sleep interventions.

【 授权许可】

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