Efficacy of a Brief Nightmare Treatment for Veterans
Condition: Sleep Disorders; PTSD; Suicide
MeSH terms: Sleep Wake Disorders; Suicide
Study type: Interventional

Summary: 
      The purpose of this study is to find out what effects Exposure, Rescripting, and Relaxation
      Therapy (ERRT) has on nightmares and associated problems in veterans.
    

Detailed description: 
      The purpose of the proposed pilot study is to extend previous findings regarding the impact
      of a brief cognitive behavioral treatment for chronic nightmares by examining the emotional,
      cognitive, behavioral, and health-related changes following treatment. Experiencing a
      traumatic event may initiate or exacerbate the occurrence of nightmares. Indeed, sleep
      disturbance, including nightmares, is considered a hallmark of posttraumatic stress disorder
      (PTSD). Nightmares have been related to a variety of factors including stress, medications,
      trauma, and substance use. Among veterans, especially combat veterans or those reporting
      sexual assaults, symptoms of traumatic stress and nightmares are extremely common. Few
      studies have investigated the efficacy of nightmare treatment in a veteran population, and
      the impact of nightmare treatment on suicidal ideation has never been assessed.

      Imagery Rehearsal Treatment (IRT) has received increased attention in the past decade for use
      with chronic nightmares. Studies suggest that the treatment is promising for the reduction of
      frequency and intensity of chronic nightmares in trauma exposed persons and may have a
      generalized impact on symptoms of posttraumatic stress disorder and depression and
      quality/quantity of sleep, although there is mixed evidence for sleep improvement among
      veterans. The principal investigator has completed two randomized controlled trials of a
      modified version of IRT, Exposure, Rescripting, and Relaxation Treatment (ERRT) and is
      currently conducting a third randomized controlled trial (Davis, 2008; Davis & Wright, 2007).
      The current randomized controlled trial is comparing ERRT to an active treatment
      (relaxation). Results demonstrated positive treatment response. Although these trials have
      included some veteran participants, veterans have not been studied as a group using this
      protocol. The purpose of this prospective study is to conduct a pre- and post-treatment
      comparison of suicidal ideation and posttraumatic, depressive, and health symptoms in a
      single group of veterans.
    

Intervention name(s): exposure, relaxation, and rescription therapy
Intervention type(s): Behavioral
Intervention description(s): veterans reporting chronic nightmares at least once per week for the past month who consent to participate will attend four consecutive weekly sessions lasting approximately two hours each. Participants will log their sleep events and associated symptoms (i.e. PTSD, depression, etc.)
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Nightmare; PTSD; Posttraumatic stress disorder; Suicide; Exposure Relaxation Rescription Therapy; Sleep