Applications of cognitive-behavioral therapy to posttraumatic stress disorder: A focus on sleep disorders

Sleep disturbances following exposure to a traumatic event are considered harbinger of posttraumatic stress disorder (PTSD) and are responsible for excessive daytime sleepiness, memory impairment, and reduced quality of life. Interventions targeting PTSD may alleviate coexisting insomnia and nightmares, but these sleep ailments persist even with significant improvement in PTSD symptoms. Sleep-specific cognitive-behavioral therapies, including cognitive-behavioral therapy (CBT) for insomnia, image rehearsal therapy, rescripting, and relaxation therapy, have been considered the preferred approach either as a standalone therapy or in combination with other psychological treatments in modifying the clinical course of PTSD. The current chapter examines the various aspects of sleep-focused CBTs delivery, limitations, and overall efficacy in restoring sleep architecture and mitigating PTSD symptoms.