![]() For instance, evidence now suggests that sleep disturbance can precede or follow the onset of depression, suggesting that in some cases, sleep disturbance can increase the likelihood of depressive symptoms, including in veterans. ![]() The co-occurrence of mental and physical symptoms with sleep disturbance can add complexity to this health issue. Moreover, military service can have additional repercussions for postdeployment reintegration into civilian life, including greater risk for specific psychiatric comorbidities of sleep disturbance such as posttraumatic stress disorder (PTSD), depression, and chronic pain. ![]() These include unusual sleep–wake schedules because of military work schedules, separation from family and loved ones, poor sleeping conditions that are detrimental to good sleep hygiene, and threat of or actual injury to self or others and associated subjective arousal. There are both service-related and psychological reasons why sleep disturbances can emerge during deployment and endure past active military service. According to an evaluation of medical records of approximately 10 million US veterans, 91% were prescribed at least one sleep medication, with sleep apnea (47%) and insomnia (26%) being two of the most common diagnoses. Sleep disturbances, especially chronic insomnia (difficulty falling and staying asleep), are among the most prevalent complaints following military deployments, particularly in post-9/11 veterans of Operations Enduring Freedom, Iraqi Freedom, and New Dawn. We also observed a significant but modest increase in objective sleep efficiency ( P=.02).Ĭonclusions: These findings suggest that the use of a mobile app–delivered CBTI is feasible and beneficial for improving sleep outcomes in veterans with insomnia, including those with comorbid conditions such as posttraumatic stress disorder or mild-to-moderate sleep apnea. Improvements in subjective sleep outcomes were similar in those with and without posttraumatic stress disorder and mild-to-moderate sleep apnea. Results: Although the PA manipulation was unsuccessful, both groups of veterans using the CBT-i Coach app showed significant improvement from baseline to postintervention on insomnia ( P<.001), sleep quality ( P<.001), and functional sleep outcomes ( P=.002). Methods: A total of 33 veterans (mean age 37.61 years, SD 9.35 years) reporting chronic insomnia were randomized to use either the CBT-i Coach app alone or the CBT-i Coach app with a PA intervention over 6 weeks, with outcome measures of objective and subjective sleep at pre- and posttreatment. This study also aims to investigate whether the use of the CBT-i Coach app with adjunctive PA improves sleep outcomes more than CBT-i Coach alone. Objective: This study aims to extend and replicate prior pilot work to examine whether the use of a mobile app for CBTI (cognitive behavioral therapy for insomnia coach app ) improves subjective and objective sleep outcomes. Technology-based solutions and lifestyle changes, such as physical activity (PA), offer affordable and accessible self-management alternatives to in-person CBTI. Cognitive behavioral therapy for insomnia (CBTI) can be effective for treating insomnia, although many cannot access this care. Mental Illness Research, Education, and Clinical CenterĮmail: Insomnia is a prevalent and debilitating disorder among veterans. ![]() Asian/Pacific Island Nursing Journal 10 articles.JMIR Bioinformatics and Biotechnology 32 articles.JMIR Biomedical Engineering 68 articles.Journal of Participatory Medicine 78 articles.JMIR Perioperative Medicine 89 articles.JMIR Rehabilitation and Assistive Technologies 201 articles. ![]() JMIR Pediatrics and Parenting 279 articles.Interactive Journal of Medical Research 306 articles.JMIR Public Health and Surveillance 1141 articles.Journal of Medical Internet Research 7471 articles. ![]()
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