Article

Sleep difficulty is a prevalent problem among returning Veterans. Although there
is strong evidence for the efficacy and durability of cognitive-behavioral
treatment for insomnia (CBT-I) in the general population, the interventions
require motivation, attention, and adherence from patients to achieve successful
outcomes. Given the unique characteristics of Operation Iraqi Freedom/Operation
Enduring Freedom (OIF/OEF) Veterans who have experienced blast-related injuries
and other trauma, CBT-I for these patients may require modification, including
alternative delivery methods, to ensure effective implementation and positive
outcomes. We interviewed 18 OIF/OEF Veterans who screened positive for mild
traumatic brain injury and 19 healthcare providers to determine the acceptability
of insomnia treatments and preferences for the interventions and treatment
delivery. Veterans and providers had distinct preferences for insomnia treatment
and its delivery. The treatments the Veterans found most acceptable were also the
ones they preferred: relaxation treatment and pharmacotherapy. The providers
identified relaxation therapy as the most acceptable treatment. Veterans
preferred the individual treatment format as well as electronic methods of
treatment delivery. Despite some differences between patients and providers, a
compromise through modification of empirically supported behavioral treatments is
feasible, and implications for preference-based insomnia intervention development
and testing are discussed.

Langue : ANGLAIS