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Our Next Lecture

PTSD and Insomnia: Cultural and Clinical Considerations

Elissa McCarthy, PhD

Wednesday, December 15 at 2:00pm ET 

PTSD and Insomia Infographic. Click to download PDF.

About the Presenter

ELISSA MCCARTHY, PhD is a clinical psychologist who specializes in the assessment and treatment of PTSD and insomnia. She is a consultant in the PTSD Consultation Program and a psychotherapist in the VA Connecticut Healthcare System, where she previously worked as a member of the PTSD Residential Rehabilitation Treatment Program treatment team and was the New England regional leader of the VA local evidence-based psychotherapy coordinators. She is a master trainer for VA's Cognitive Behavioral Therapy for Insomnia national rollout. Dr. McCarthy's current research interests are focused on studying the effectiveness and implementation of evidence-based psychotherapies for PTSD and insomnia. Dr. McCarthy received her Ph.D. from the University of Connecticut and completed a VA postdoctoral fellowship at the VISN 1 Mental Illness Research, Education and Clinical Centers (MIRECC) site.

About the Topic

Many individuals diagnosed with PTSD also report difficulty sleeping. After successful treatment of PTSD, sleep disruption is frequently reported as a persistent symptom that continues to disrupt functioning and quality of life. Increasingly, clinicians recognize the need for independent evaluation of sleep difficulties for individuals with PTSD rather than assuming that reported sleep difficulties are a resulting symptom of PTSD.

Chronic insomnia disorder is one of the most common sleep disorders diagnosed among individuals with PTSD, often requiring separate intervention. Multiple national and international clinical practice guidelines for the treatment of PTSD recommend trauma-focused psychotherapies as front-line treatment (e.g., manualized individual trauma-focused); for insomnia, the front-line recommendation is cognitive behavioral therapy. However, the research has limited guidance and limited established evidence-based protocols for treatment when PTSD and insomnia are comorbid.

This presentation will review the most up-to-date evidence related to considerations for integrated, sequential and concurrent treatment options for comorbid PTSD and insomnia. Additionally, learners will be able to identify cultural and clinical considerations related to the assessment and treatment of these comorbid disorders to help inform case conceptualization and shared decision-making.

Featured Article

Sleep Problems in Veterans with PTSD

Sleep problems—in particular chronic insomnia and nightmares—are frequently some of the most troubling aspects of PTSD. While these sleep problems are considered symptoms of PTSD, the evidence suggests that they tend to become independent problems over time that warrant sleep-focused assessment and treatment. There are both pharmacologic and cognitive behavioral treatment options available.

Read the full article

Free Resources

Patient Education

Almost everyone with PTSD reports sleep problems. In fact, trouble sleeping is the main reason that people first go to a doctor to get help for PTSD. Both insomnia—trouble falling or staying asleep—and nightmares are PTSD symptoms.

Share this webpage with you patients to help them learn more: Sleep Problems and PTSD.  It contains brief videos that help to explain the information in plain language.  

It includes an overview of common problems and then explains treatment options including a chart that compares CBT-I and medication.

EXPLORE MORE PATIENT-EDUCATION OPTIONS (Videos, Apps, Handouts)

Mobile Phone Apps 

The National Center for PTSD has created two mobile phone apps that can help with sleep-related problems.  To learn more about how to integrate technology into care for Veterans, visit our Tech into Care section.  

CBT-i Coach is a mobile app for people who are engaged in CBT-I (Cognitive Behavioral Therapy for Insomnia) with a health provider, or who have experienced symptoms of insomnia and would like to improve their sleep habits.

The Insomnia Coach app was created for everyone to help manage insomnia. It is based on Cognitive Behavioral Therapy for Insomnia (CBT-I).

This online course is also available (no smart phone required):  Path to Better Sleep

Are you treating U.S. Veterans?

Our team of expert clinicians is available to consult with any healthcare provider treating U.S. veterans in any setting.   We can discuss assessment, diagnosis, psychotherapy, medications, collaborating with VA care, patient and family education, continuing education, and just about anything else related to veterans and PTSD.  No question is too big or too small. Contact us at PTSDconsult@va.gov or 866-948-7880.