Special considerations in the adaptation of cognitive behavioral therapy for insomnia with active duty US Army personnel.

Pruiksma, K. E., Fina, B., Dietch, J. R., Dondanville, K. A., Williams, J., Wright, E. C., Molino, A., Hall-Clark, B., Nicholson, K. L., Peterson, A. L., & Taylor, D. J., for the STRONG STAR Consortium.
Nov 1, 2018

Cognitive and Behavioral Practice, 25(4), 515-530.

Insomnia is highly prevalent among active-duty military service members. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a well-established and effective treatment; however, research and treatment recommendations have primarily focused on civilian or veteran populations. A multitude of military-specific factors directly impact service members’ sleep and the subsequent treatment recommendations. This article provides treatment considerations for the use of CBT-I with active-duty U.S. Army personnel. First, an overview of the theoretical model of insomnia, including military-specific predisposing, precipitating, and perpetuating factors, is presented, followed by a review of common comorbid conditions among service members with insomnia. Finally, discussion focuses on considerations and strategies for implementing components of CBT-I with service members, managing sleep during deployments, and adjusting sleep to accommodate overnight duties. Additional training resources and supplemental video examples (with actors) are provided.

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