Follow-Up Analyses From a Wait-List Controlled Trial of Occupational Therapist-Delivered Cognitive- Behavioral Therapy for Insomnia Among Veterans With Chronic Insomnia

Abstract

Importance: Veterans often experience chronic insomnia, and professionals capable of delivering effective interventions to address this problem are lacking. Objective: To evaluate the efficacy of the Restoring Effective Sleep Tranquility (REST) program, an occupational therapist-led cognitive-behavioral therapy for insomnia (CBT-I) intervention to treat sleep problems among post- 9/11 veterans. Design: Wait-list controlled trial with 3-mo follow-up. Setting: Community-based veteran support program in a Mountain West university. Participants: Fifteen post-9/11 veterans with sleep disturbances who were assigned to either the REST intervention or a wait-list control group. Outcomes and Measures: Sleep-related, health-related, and participation-related patient-reported outcomes (PROs) and daily sleep diary variables. Results: Wait-list controlled trial benefits included improved sleep-related (e.g., sleep disturbance), health-related (e.g., depression), and participation-related (e.g., meaningful activity) PROs. Findings were confirmed after participants in both the intervention and the control groups (n 5 13) received the REST intervention, including improved daily sleep diary outcomes (e.g., sleep efficiency). All gains were maintained at 3 mo. Conclusions and Relevance: Occupational therapy practitioners with advanced training in CBT-I have the potential to safely deliver an effective CBT-I intervention to veterans with sleep disturbances in a communitybased setting.