Psychological treatment for sleep disturbances in treating post-traumatic stress disorder symptoms: a meta-analysis of randomized controlled trials

Abstract

Sleep disturbances are frequently reported in patients with PTSD. Sleep-specific psychological treatments provide an alternative to conventional trauma-focused treatments. The current meta-analysis evaluated the efficacy of sleep-specific psychological treatment in alleviating PTSD, sleep, and depressive symptoms. A total of 12 studies were included in the meta-analytic comparisons between sleep-specific psychological treatments and waiting-list control groups at post-treatment. Random effects models showed significant reduction in self-report PTSD and depression symptoms, and insomnia severity in the sleep-specific treatment group. The corresponding effect sizes, measured in Hedges’ g, were 0.58, 0.44, and 1.15, respectively. The effect sizes for sleep diary-derived sleep onset latency, wake after sleep onset, and sleep efficiency were 0.83, 1.02 and 1.15, respectively. The average study attrition rate of sleep-specific treatment was relatively low (11.7%), with no significant difference from the control group (8.6%). In conclusion, sleep-specific psychological treatments appear to be efficacious and feasible in treating PTSD. Due to the relatively small number of randomized controlled trials available, further research is warranted to confirm its efficacy and acceptability, especially in comparison to trauma-specific treatments.