Insomnia And Nightmares

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Several studies found that alcohol abuse and suicidal ideation was usually accompanied by trauma related insomnia and nightmares. In a longitudinal study, Pigeon, Campbell, Possemato, & Ouimette (2013), examined the prevalence of insomnia and nightmares after six months in eighty combat veterans who met the criteria for sub threshold PTDS. Interviews and self-reports were conducted to measure the severity of insomnia and/or nightmares associated with PTSD (Pigeon et al., 2013). Results indicated that a high PTSD symptom severity level was associated with insomnia; more frequent nightmares; greater alcohol use; and symptoms of depression in the past six months (Pigeon et al., 2013). After six months, veterans were reassessed for whether the insomnia and nightmares frequencies had improved (Pigeon et al., 2013). Out of the entire group of veterans “74% presented with insomnia and 61% endorsed distressing nightmares” (Pigeon et al., 2013, p.549). By the end of the six months, veterans reported a 26% decline in nightmares and a no change in insomnia (Pigeon et al., 2013). The findings demonstrated “a strong association between the presence of sleep disturbance (both insomnia and nightmares) and the severity of both PTSD and depressive symptoms; that the persistence of these symptoms is particularly associated with insomnia; and that insomnia itself does not spontaneously resolve” (Pigeon et al., 2013, p.549). This research established the need for MHNs to implement interventions that will help individuals to cope with the trauma related distress that could contribute drug abuse; suicidal ideation; and insomnia and nightmares. Early interventions for PTSD are necessary to control, reduce or prevent symptoms and the risks they ma...

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...ans after the implementation of imagery rehearsal (Harb et al., 2012). Veterans found it useful to “devise an alternate ending to the dream, using distancing techniques, and transforming weapons into harmless objects” (Harb et al., 2012, p.516). The study also concluded that individuals would experience superior results if they excluded violent details in the rescription of the nightmare, as those might become triggers of trauma related memories (Harb et al., 2012). MHNs need to inform patients about the effectiveness of exposure therapy and imagery rehearsal, which in turn, would minimize the distress experienced, and decrease PTSD symptom severity (Harb et al., 2012). Decreased distress may reduce insomnia and nightmares as well as, the risk of alcohol abuse and suicidal ideations in patients suffering from the distress, anxiety, and stress of PTSD symptoms.

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