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Study will lead to a treatment to address sleep problems that may relieve Post-traumatic Stress Disorder and depression.

By Rebecca Ruiz-McGill,
August 15, 2008

The University of Arizona and the Southern Arizona VA Healthcare System are conducting a joint study that aims to create a non-medication-based therapy to treat sleep disturbances in war veterans and active duty personnel, most notably those who have recently returned from Iraq and Afghanistan.

The study is led by Patricia Haynes, clinical psychologist and research assistant professor in the UA’s psychiatry department. Haynes sees patients at the VA, where she runs the Behavioral Sleep Medicine Clinic. In the clinic, she provides individual and group cognitive behavioral therapy for insomnia and nightmares.

“Several studies show sleep problems may precede Post-traumatic Stress Disorder and depression,” Haynes said. “Our hope is that, by treating sleep problems right away, we may potentially prevent problems like depression and PTSD down the line.”

Haynes describes the issues which prevent substantive sleep for those engage in combat:

• hyper alertness due to being constantly on guard for danger.
• extensive sleep deprivation.
• shift work that misaligns the body clock.
• Insomnia and nightmares.

"When military personnel return home, sleep issues can contribute to substance abuse, depression and PTSD. Veterans often report experiencing cold sweats during sleep, jumpiness when trying to fall asleep, fighting out dreams and even sleeping with a gun near the bed to calm their state of mind," Haynes said.

Haynes partnership with the VA and their team of experts is a model of the VA’s mission. “Research and medical care and training are key mission components of the VA system. VA hospitals are affiliated with universities in their communities to collaborate on research that will enhance the quality of life of veterans, spouses, survivors and dependents,” said Dr. Sairam Parthasarathy, chief of research at the Southern Arizona VA Healthcare System.

Parthasarathy and Haynes share a background in sleep research and Parthasarathy has also noted the common concerns of sleep deprivation among veterans returning from Iraq and Afghanistan.

His contributions to the research includes the assessment of any influences that may be affecting the veterans’ ability to sleep. “There may be sleep apnea issues, breathing disorders, brain injuries, neurological problems or medications that are complicated the insomnia that need to be considered,” Parthasarathy added.

The study has three phases. The first phase involves gathering information from military personnel via focus groups. The focus groups will provide data on sleep issues faced by veterans who have returned from fighting in Iraq and Afghanistan. The veterans recruited for the study will be those who have returned from Iraq and Afghanistan within the last two years.

The second phase involves gathering feedback from national experts who have experience in treating the issues the veterans identified during the focus groups. After this phase, a comprehensive treatment will be developed based on the expert recommendations. The final component will be testing the treatment in military personnel and veterans who have returned from combat within the last six months.

Non-medication-based therapy is an important component of the study. “Research studies show that behavioral treatments for insomnia work just as well as medications in the short-term and better than medications in the long-term. Over time, sedative medications often stop having the same effects than when you first started taking them. Our goal is to learn how to modify these behavioral therapies to address unique issues that military personnel face with their sleep,” Hayes said.

The Southern Arizona VA Healthcare System is the primary provider of mental health care for veterans returning to southern Arizona from Iraq and Afghanistan according to Dr. David C. Emelity, Southern Arizona VA Healthcare System chief of mental healthcare and UA assistant professor of clinical psychiatry.

“We have been expanding our mental health programs over the last three years in order to meet their needs," Emelity said. "Forty-five new positions in mental health care have been added, new programs created and existing programs expanded for the reintegration and care of these returning soldiers."