{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:50:29Z","timestamp":1789843829373,"version":"4.0.1"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["I01CX001136\u201001"],"award-info":[{"award-number":["I01CX001136\u201001"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH\u201013\u20102\u20100065"],"award-info":[{"award-number":["W81XWH\u201013\u20102\u20100065"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Traumatic Stress"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Insomnia and nightmares are common in patients with posttraumatic stress disorder (PTSD). They are associated with worse psychological and physical health and worse PTSD treatment outcomes. In addition, they are resistant to PTSD treatments, which do not typically address sleep disorders. Cognitive behavioral therapy for insomnia and nightmares (CBT\u2010I&amp;N) and cognitive processing therapy (CPT) for PTSD are first\u2010line treatments, but limited evidence exists guiding the treatment of individuals with all three disorders. The current study randomized U.S. military personnel (\n                    <jats:italic>N<\/jats:italic>\n                    = 93) to one of three conditions: CBT\u2010I&amp;N delivered before CPT, CBT\u2010I&amp;N delivered after CPT, or CPT alone; all groups received 18 sessions. Across groups, participants demonstrated significantly improved PTSD symptoms. Because the study was terminated prematurely due to challenges with recruitment and retention, it was underpowered to answer the initially intended research questions. Nonetheless, statistical findings and relevant clinically meaningful changes were observed. Compared to participants who received CPT alone, those who received CBT\u2010I&amp;N and CPT, regardless of sequencing, demonstrated larger improvements in PTSD symptoms,\n                    <jats:italic>d<\/jats:italic>\n                    = \u22120.36; insomnia,\n                    <jats:italic>d<\/jats:italic>\n                    = \u22120.77; sleep efficiency,\n                    <jats:italic>d<\/jats:italic>\n                    = 0.62; and nightmares,\n                    <jats:italic>d<\/jats:italic>\n                    = \u2212.53. Compared to participants who received CBT\u2010I&amp;N delivered before CPT, those who received CBT\u2010I&amp;N delivered after CPT demonstrated larger improvements in PTSD symptoms,\n                    <jats:italic>d<\/jats:italic>\n                    = 0.48, and sleep efficiency,\n                    <jats:italic>d<\/jats:italic>\n                    = \u22120.44. This pilot study suggests that treating comorbid insomnia, nightmares, and PTSD symptoms results in clinically meaningful advantages in improvement for all three concerns compared to treating PTSD alone.\n                  <\/jats:p>","DOI":"10.1002\/jts.22939","type":"journal-article","created":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T00:44:58Z","timestamp":1686876298000},"page":"712-726","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Treatment of comorbid sleep disorders and posttraumatic stress disorder in U.S. active duty military personnel: A pilot randomized clinical trial"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3433-2516","authenticated-orcid":false,"given":"Daniel J.","family":"Taylor","sequence":"first","affiliation":[{"name":"Department of Psychology University of Arizona  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6585-4670","authenticated-orcid":false,"given":"Kristi E.","family":"Pruiksma","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio  San Antonio Texas USA"},{"name":"Research and Development Service South Texas Veterans Health Care System  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8299-5851","authenticated-orcid":false,"given":"Jim","family":"Mintz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio  San Antonio Texas USA"},{"name":"Research and Development Service South Texas Veterans Health Care System  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-4895","authenticated-orcid":false,"given":"Danica C.","family":"Slavish","sequence":"additional","affiliation":[{"name":"Department of Psychology University of North Texas  Denton Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1523-7564","authenticated-orcid":false,"given":"Sophie","family":"Wardle\u2010Pinkston","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Arizona  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9434-0791","authenticated-orcid":false,"given":"Jessica R.","family":"Dietch","sequence":"additional","affiliation":[{"name":"School of Psychological Science Oregon State University  Corvallis Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4204-7926","authenticated-orcid":false,"given":"Katherine A.","family":"Dondanville","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3327-5233","authenticated-orcid":false,"given":"Stacey","family":"Young\u2010McCaughan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio  San Antonio Texas USA"},{"name":"Research and Development Service South Texas Veterans Health Care System  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2795-0503","authenticated-orcid":false,"given":"Karin L.","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Department of Medicine Carl R. Darnall Army Medical Center  Fort Hood Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0479-8887","authenticated-orcid":false,"given":"Brett T.","family":"Litz","sequence":"additional","affiliation":[{"name":"Massachusetts Veterans Epidemiological Research and Information Center VA Boston Healthcare System  Boston Massachusetts USA"},{"name":"Department of Psychiatry Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"},{"name":"Department of Psychological and Brain Sciences Boston University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0482-3149","authenticated-orcid":false,"given":"Terence M.","family":"Keane","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Boston University Chobanian &amp; Avedisian School of Medicine  Boston Massachusetts USA"},{"name":"Behavioral Sciences Division National Center for PTSD at VA Boston Healthcare System  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2947-2936","authenticated-orcid":false,"given":"Alan L.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center at San Antonio  San Antonio Texas USA"},{"name":"Research and Development Service South Texas Veterans Health Care System  San Antonio Texas USA"},{"name":"Department of Psychology University of Texas at San Antonio  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2203-2404","authenticated-orcid":false,"given":"Patricia A.","family":"Resick","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke Health  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Consortium to Alleviate PTSD","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,15]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"American Psychiatric Association. 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