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Recent Advancements in Treating Sleep Disorders in Co-Occurring PTSD

  • Anxiety Disorders (A Pelissolo, Section Editor)
  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Comorbidity of posttraumatic stress disorder (PTSD) and insomnia, nightmares, and obstructive sleep apnea (OSA) is high. We review recent research on psychotherapeutic and pharmacological interventions for sleep disorders in PTSD.

Recent Findings

PTSD treatments decrease PTSD severity and nightmare frequency, but do not resolve OSA or insomnia. Research on whether insomnia hinders PTSD treatment shows mixed results; untreated OSA does interfere with PTSD treatment. Cognitive behavioral therapy for insomnia is the recommended treatment for insomnia; however, optimal ordering with PTSD treatment is unclear. PTSD treatment may be most useful for PTSD-related nightmares. CPAP therapy is recommended for OSA but adherence can be low.

Summary

Targeted treatment of sleep disorders in the context of PTSD offers a unique and underutilized opportunity to advance clinical care and research. Research is needed to create screening protocols, determine optimal order of treatment, and elucidate mechanisms between sleep and PTSD treatments.

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Acknowledgments

The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government. Writing was supported by VA RR&D CDA Grant #1lK2Rx002120-01 (P.J.C.) and by the Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, Department of Veterans Affairs (L.D.S. and L.A.G.).

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Authors and Affiliations

  1. VA San Diego Healthcare System, University of California San Diego, 3350 La Jolla Village Dr. (116B), San Diego, CA, 92161, USA

    Peter J. Colvonen, Carl Stepnowsky, Michael J. McCarthy & Sonya B. Norman

  2. Center of Excellence for Stress and Mental Health, University of California San Diego, San Diego, CA, USA

    Peter J. Colvonen & Sonya B. Norman

  3. Department of Psychiatry, University of California San Diego, San Diego, CA, USA

    Peter J. Colvonen, Michael J. McCarthy & Sonya B. Norman

  4. Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco VA Healthcare System, San Francisco, CA, USA

    Laura D. Straus & Lizabeth A. Goldstein

  5. Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA

    Laura D. Straus & Lizabeth A. Goldstein

  6. Department of Medicine, University of California, San Diego, San Diego, CA, USA

    Carl Stepnowsky

  7. National Center for PTSD, Boston, MA, USA

    Sonya B. Norman

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  1. Peter J. Colvonen
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  2. Laura D. Straus
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  5. Lizabeth A. Goldstein
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  6. Sonya B. Norman
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Correspondence to Peter J. Colvonen.

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P.J.C., L.D.S., C.S., L.A.G., and S.B.N. each declare no potential conflicts of interest.

M.J.M. is an unpaid member of the scientific advisory board for Owaves.

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This article is part of the Topical Collection on Anxiety Disorders

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Colvonen, P.J., Straus, L.D., Stepnowsky, C. et al. Recent Advancements in Treating Sleep Disorders in Co-Occurring PTSD. Curr Psychiatry Rep 20, 48 (2018). https://doi.org/10.1007/s11920-018-0916-9

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