title: Treatment of sleep disturbances in posttraumatic stress disorder: a review.
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.
authors.affiliation: San Francisco Department of Veterans Affairs (VA) Medical Center, San Francisco, CA 94121, USA. Frank.schoenfeld@va.gov
authors.forename: Frank B
authors.initials: FB
authors.lastname: Schoenfeld
authors.forename: Jason C
authors.initials: JC
authors.lastname: Deviva
authors.forename: Rachel
authors.initials: R
authors.lastname: Manber
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D004325:Dreams / Q000523:psychology; D006077:Government Agencies; D006801:Humans; D019018:Imagery, Psychotherapy; D017410:Practice Guidelines as Topic; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000628:therapy*; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D014149:Tranquilizing Agents / Q000627:therapeutic use*; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D000928:Antidepressive Agents; D014149:Tranquilizing Agents