Sleep Disturbance Clinical Trial
Official title:
Acupuncture for Sleep Disturbances in Post-Deployment Military Service Members
This randomized study will evaluate the effect of a brief acupuncture therapy in addition to a brief cognitive behavioral therapy in mitigating sleep disturbances in post-deployment military service members using reliable and valid measures.
Introduction: Sleep disturbance is a hallmark symptom of posttraumatic stress disorder (PTSD)
and an important antecedent in PTSD recovery in service members who were deployed to
Operation Enduring Freedom and Operation Iraqi Freedom. Sleep disturbances (SDs) are
important maintainers of PTSD symptoms in service members. Yet, they remain resistant to
treatment for many service members. To mitigate the consequences of allostatic load,
researchers have investigated the effects of acupuncture as a promising intervention.
Objectives/Aims: The overall goal of this study is to evaluate the effectiveness and
perceived benefits of a manual standardized acupuncture (MSSA) as an adjunct therapy to an
abbreviated cognitive behavioral therapy (ACBT) in the treatment of SDs in post-deployment
military service members. Specific aims include the following: a) To evaluate the
effectiveness of MSSA as an adjunct treatment with ACBT, as compared to ACBT alone, for SDs
using the Insomnia Severity Index (ISI) and Pittsburg Sleep Quality Index (PSQI) in
post-deployment military service members, b) To describe the perceived benefit of MSSA as an
adjunct treatment with ACBT, as compared with ACBT alone, for SDs using journal log entries
in post-deployment military service members, and c) To explore the influence of participant
expectation on the effectiveness of acupuncture on SDs using the Acupuncture Expectancy Scale
(AES) in post-deployment military service members in the experimental group.
Methods and Analysis: This is a two-arm, single-center randomized controlled trial in U.S.
Naval Hospital, Okinawa, Japan. A random assignment process will be conducted by the primary
investigator using permutated block randomization. Service members who meet the study
selection criteria and decide to participate will be randomly assigned to either the
experimental or control group: 1) Experimental: MSSA and ACBT, or 2) Control: ACBT only and
waitlist for acupuncture. Patient-reported questionnaires including ISI, PSQI, and AES will
be administered at baseline and then at the completion of the study. Descriptive statistics,
reliable change indices, and mixed effects generalized linear models that correct standard
errors for repeated assessments will be used to test for the interactive effect of
acupuncture treatment and time in the study on each outcome controlling for respective
baseline values.
Military Relevance: Given the role of sleep disturbances in posttraumatic stress disorder in
the military, intervening early before service members become at risk for severe injuries,
hospitalizations, and chronic disability could help decrease burdensome problems.
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