Journal of Rehabilitation Research & Development (JRRD)

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Volume 49 Number 5, 2012
   Pages 729 — 752

Abstract — Treatment of sleep disturbances in posttraumatic stress disorder: A review

Frank B. Schoenfeld, MD;1* Jason C. DeViva, PhD;2 Rachel Manber, PhD3
1San Francisco Department of Veterans Affairs (VA) Medical Center; University of California San Francisco, School of Medicine, San Francisco, CA; 2VA Connecticut Health Care System, West Haven, CT; University of Connecticut School of Medicine, Farmington, CT; and Yale University School of Medicine, New Haven, CT; 3Stanford University School of Medicine, Stanford, CA

Abstract–Sleep disturbances are among the most commonly reported posttraumatic stress disorder (PTSD) symptoms. It is essential to conduct a careful assessment of the presenting sleep disturbance to select the optimal available treatment. Cognitive-behavioral therapies (CBTs) are at least as effective as pharmacologic treatment in the short-term and more enduring in their beneficial effects. Cognitive-behavioral treatment for insomnia and imagery rehearsal therapy have been developed to specifically treat insomnia and nightmares and offer promise for more effective relief of these very distressing symptoms. Pharmacotherapy continues to be an important treatment choice for PTSD sleep disturbances as an adjunct to CBT, when CBT is ineffective or not available, or when the patient declines CBT. Great need exists for more investigation into the effectiveness of specific pharmacologic agents for PTSD sleep disturbances and the dissemination of the findings to prescribers. The studies of prazosin and the findings of its effectiveness for PTSD sleep disturbance are examples of studies of pharmacologic agents needed in this area. Despite the progress made in developing more specific treatments for sleep disturbances in PTSD, insomnia and nightmares may not fully resolve.

Key words: antidepressant, antipsychotic, anxiolytic, behavioral, cognitive, desensitization, imagery, insomnia, nightmare, pharmacologic, polysomnography, posttraumatic, prazosin, sleep, stress, trauma, veterans.


View HTML  ¦  View PDF  ¦  Contents Vol. 49, No. 5
This article and any supplementary material should be cited as follows:
Schoenfeld FB, DeViva JC, Manber R. Treatment of sleep disturbances in posttraumatic stress disorder: A review. J Rehabil Res Dev. 2012;49(5):729–52.
http://dx.doi.org/10.1682/JRRD.2011.09.0164
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Last Reviewed or Updated  Wednesday, July 18, 2012 9:25 AM

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