Increasing Access to Insomnia Treatment to Decrease Suicide Risk through Computerized Insomnia Programs
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Denver VA Medical Center and the University of Colorado Medical Center

Chronic sleep problems are a major and growing complaint among Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) military service members and veterans. Insomnia is associated with a host of physical and mental health impairments, including suicidal thoughts and behaviors, as well as other disorders that are associated with increased risk for suicide.

Although Cognitive Behavioral Therapy for Insomnia (CBT-I) is an effective treatment for insomnia, access to CBT-I is limited for several reasons, including a lack of trained clinicians. Dr. Sarra Nazem, a psychologist at the Rocky Mountain Regional VA Medical Center, aims to address this limitation by studying a computerized, self-guided, web-based version of CBT-I.

Nazem plans to conduct a randomized controlled trial examining whether this computerized web-based version of CBT-I is efficacious in reducing insomnia symptoms and improving overall mental health functioning among OEF/OIF/OND veterans. Specifically, she will recruit 266 OEF/OIF/OND veterans who will complete two weeks of sleep diaries prior to enrollment. Following baseline assessment, they will then be randomized to one of two computerized insomnia programs. After completing one of these interventions, veterans will complete follow-up assessments post-intervention and at six-month and one-year follow-up. Nazem will then examine whether the computerized web-based version of CBT-I results in a reduction of insomnia symptoms across the study period.

Overall, this approach could be valuable, as insomnia complaints are common among service members and veterans, and have large impacts on physical and mental health functioning. If found to be efficacious, a computerized, self-guided evidence-based treatment has high potential for dissemination and implementation as an inexpensive and easy-to-administer treatment for insomnia, which may in turn reduce suicide risk.

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