Improving sleep in a population at high risk of trauma: A pilot study examining self-reported sleep, psychological symptomology and actigraphy measured night-time sleep

Abstract

Introduction Sleep disturbances (SDs), such as insomnia or regular nightmares, are associated with multiple mental health disorders, most notably PTSD, where SDs are reported in up to 92% of cases. Examining the effect of changing sleep on psychological symptomology is essential to develop the evidence base on the contribution of sleep to mental resilience. Objectives To examine the effect a short skills-based sleep intervention on psychological symptomology and actigraphy measured sleep. Methods A 4-session sleep skills training programme was used to treat active SDs in participants likely to have experienced occupation-associated trauma, namely military and first responders. Results Nineteen participants were included in the study. Insomnia Severity Index (ISI) measured; difficulty sleeping, difficulty staying asleep, waking too early, sleep satisfaction, sleep interference on quality of life and total ISI insomnia score improved significantly post-treatment (M = 9.44, SE = 7.35, p <0.001). No significant difference was identified post-treatment for actigraphy-measured sleep. The severity of depression (M = 5.27, SE = 1.41, p = 0.002), anxiety (M = 5.07, SE = 1.66, p = 0.008), and PTSD symptoms among participants with likely PTSD, were significantly lower following treatment (M = 29.4, SE = 4.19, p = 0.002). Conclusions A short sleep skills intervention based on CBT-I was effective at reducing self-report insomnia symptoms and severity of psychological symptomology but failed to improve actigraphy sleep metrics. These findings highlight a differing contribution of night-time sleep and current insomnia symptoms to the severity of self-reported psychological symptomology.