title: Augmenting cognitive processing therapy to improve sleep impairment in PTSD: A randomized controlled trial.
abstract: OBJECTIVE
  Despite the success of empirically supported treatments for posttraumatic stress disorder (PTSD), sleep impairment frequently remains refractory after treatment. This single-site, randomized controlled trial examined the effectiveness of sleep-directed hypnosis as a complement to an empirically supported psychotherapy for PTSD (cognitive processing therapy [CPT]).
  
  
  METHODS
  Participants completed either 3 weeks of hypnosis (n = 52) or a symptom monitoring control condition (n = 56) before beginning standard CPT. Multilevel modeling was used to investigate differential patterns of change to determine whether hypnosis resulted in improvements in sleep, PTSD, and depression. An intervening variable approach was then used to determine whether improvements in sleep achieved during hypnosis augmented change in PTSD and depression during CPT.
  
  
  RESULTS
  After the initial phase of treatment (hypnosis or symptom monitoring), the hypnosis condition showed significantly greater improvement than the control condition in sleep and depression, but not PTSD. After CPT, both conditions demonstrated significant improvement in sleep and PTSD; however, the hypnosis condition demonstrated greater improvement in depressive symptoms. As sleep improved, there were corresponding improvements in PTSD and depression, with a stronger relationship between sleep and PTSD.
  
  
  CONCLUSIONS
  Hypnosis was effective in improving sleep impairment, but those improvements did not augment gains in PTSD recovery during the trauma-focused intervention. (PsycINFO Database Record
authors.affiliation: Women's Health Sciences Division, National Center for PTSD, Veteran's Affairs Boston Healthcare System.
authors.forename: Tara E
authors.initials: TE
authors.lastname: Galovski
authors.affiliation: National Center for PTSD, Executive Division.
authors.forename: Juliette M
authors.initials: JM
authors.lastname: Harik
authors.affiliation: Chase Brexton Health Care.
authors.forename: Leah M
authors.initials: LM
authors.lastname: Blain
authors.affiliation: Psychological Sciences, University of Indianapolis.
authors.forename: Lisa
authors.initials: L
authors.lastname: Elwood
authors.affiliation: Center for Trauma Recovery, University of Missouri-St. Louis.
authors.forename: Chelsea
authors.initials: C
authors.lastname: Gloth
authors.affiliation: Independent Practice.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Fletcher
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D006990:Hypnosis / Q000379:methods*; D008297:Male; D012893:Sleep Wake Disorders / Q000209:etiology / Q000628:therapy*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome