Researchers R. Bruce Lydiard, Ph.D., M.D., and Mark Hammer MD from the Ralph H. Johnson VA Medical Center in Charleston SC , are embarking on some important research that targets sleep disturbance in posttraumatic stress.  Their premise is that the first-line treatments for posttraumatic stress disorder - medication (selective serotonin reuptake inhibitors) and cognitive behavior therapy – do not adequately treat nightmares and insomnia. Nor do they feel that there is sufficient awareness in the mental health community of the critical role sleep disturbance plays in PTSD.

Researchers from Vrije Universiteit in Amsterdam, The Netherlands, examined whether a self-help intervention might offer an inexpensive and more accessible alternative to face-to-face therapy for the non-pharmacologic treatment of insomnia. 

They conducted a meta-analysis of randomized controlled studies examining the effects of self-help interventions for insomnia, identified through extensive searches of bibliographical databases.  They examined the effects of self-help on different sleep outcomes, in comparison with both wait list controls and face-to-face treatments.

Dear BR and Health Journeys,

My brother witnessed the violence at Virginia Tech.  Since then, when there is news of a mass shooting his mental health suffers.  He gets insomnia, anxiety, short temper and jumpiness during these times. He also gets an anniversary reaction each April that lasts 2-3 weeks.  

I had a terrific, informative chat with Adriana Tarazon, OEF/OIF Psychologist at the Phoenix V.A.  She’s a great proponent of guided imagery (and other mind-body methods), having used hundreds of our CDs with the men and women coming back from Iraq and Afghanistan.  As a result, she’s a mind-blowing encyclopedia of practical information about what works for returning troops and what doesn’t. 

Question:

I attended your workshop in New Orleans. I now have a client who is a perfect candidate for the repetitive nightmare treatment.  Is there someone in the New Orleans area that I can refer my client to for this -- or who can teach me how to go through the process myself with my client?  Thanks.  Roberto

Answer:

Dear Roberto,
The best expert is the wonderful psychologist who developed the method for the veterans at the Brecksville V.A. - Beverly Donovan, PhD.   Sadly for all of us, she's retired from the V.A. – she was very generous with her time and expertise while she was still working there, but, alas, she’s taken to traveling, relaxing and visiting a lot of family.  Darn, I hate it when that happens!
 

My daughter is a college freshman with insomnia. The lack of sleep created more problems for her with stress, concentration and performance. She was sleeping through some classes and her exam-taking suffered as well.  Her mood was affected.  She lost interest in her social life. There was an overall snowballing effect that had my wife and I quite concerned.  

What Helps Older Adults Sleep Better? Melatonin, Valerian, Tai Chi, Acupressure, Yoga ...

A review from the University of Pennsylvania finds several promising holistic therapies improve sleep disorders in older adults .

Research from the University of Pennsylvania School of Medicine’s Center for Sleep and Respiratory Neurobiology reviewed the growing body of well-designed clinical trials testing efficacy of complementary and alternative medicines (CAM) for sleep disorders in older adults. They point to three promising areas:

1. Melatonin is an effective agent for circadian phase sleep disorders; less clearly so for primary or secondary insomnia;
2. Valerian shows benefit in some but not all clinical trials;
3. Chi, acupuncture, acupressure, yoga, and meditation improve sleep parameters in a limited number of early trials

The author recommends that more research be done in all these areas.

Citation: Gooneratne NS. Complementary and alternative medicine for sleep disturbances in older adults. Clinics in Geriatric Medicine. 2008 Feb;24 (1): pages 121-38, viii. This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .

Hypnosis is found to be an effective form of therapy for insomnia in school age children, according to a retrospective record review at the State University of New York (S.U.N.Y.) at Syracuse..

Researchers from the State University of New York at Syracuse explored the efficacy of hypnosis for insomnia in school age children. A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea.

All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy through hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7-17). When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause.