Improving Sleep and PTSD Outcomes in Service Members: A Randomized Controlled Trial Examining the Long-Term Effects of an Integrated Treatment.

In 30 seconds

This randomized controlled trial compared Compressed Prolonged Exposure (CPE) with Trauma Management Therapy (TMT), which combines exposure therapy with sleep hygiene and other skills, in 82 active-duty service members with PTSD. PTSD symptoms and actigraphy-based sleep were assessed through 6-month follow-up. Sleep changed little immediately after treatment in either group, but TMT was associated with better outcomes over follow-up. At 6 months, TMT showed advantages in sleep quality (g = 0.70), sleep efficiency (g = 0.51), and wake after sleep onset (g = -0.52) compared with CPE.

Key findings

• At 3-month follow-up, TMT participants had better sleep efficiency (g = 0.24) and onset latency (g = -0.34) than CPE participants.
• At 6-month follow-up, TMT participants had better sleep quality (g = 0.70), efficiency (g = 0.51), and wake after sleep onset (g = -0.52) than CPE participants.
• Within both groups, poorer sleep at 6 months was correlated with greater PTSD symptom severity at that time.

Why it matters

Sleep disturbance may persist despite PTSD treatment, and this trial suggests that integrating sleep-focused components with exposure therapy can yield better objective sleep outcomes over time than exposure alone. The delayed improvements highlight the value of assessing sleep beyond the immediate posttreatment period. The concurrent association between poorer sleep and greater PTSD severity also underscores their ongoing relationship, without establishing causation.

What to keep in mind

The abstract reports follow-up only through 6 months and does not provide results beyond that period.