Feasibility Test of Preference-Based Insomnia Treatment for Iraq and Afghanistan War Veterans



Dana R. Epstein, Phoenix VA Health Care System, 650 E. Indian School Road (RS/151), Phoenix, AZ 85012.

E-mail: dana.epstein@va.gov



The study determined the feasibility of implementing a brief, preference-based non-medication insomnia treatment for Iraq/Afghanistan war Veterans who experienced blast and/or other injuries resulting in an altered level of consciousness.


The study used a one-group pre-post design with a 3-month follow-up assessment. Forty-one veterans (two females, mean age 30.32 ± 7.73 years) with a mean insomnia duration of 3.90 years (±2.03) received treatment that included one in-person and three telephone sessions of behavioral intervention and incorporated electronic delivery components. Feasibility indicators and preliminary treatment effectiveness were assessed.


Results indicate the preference-based treatment was acceptable to veterans and feasible to implement. Treatment components delivered in-person were used more than electronic methods. Insomnia decreased from moderate severity to the sub-threshold range. Pre- to post-treatment effect sizes were large for most sleep outcomes. Sleep improvement maintained at the 3-month follow-up assessment.


Further testing of a brief insomnia treatment model is needed.

Clinical Relevance

Successful insomnia treatment has the potential to maximize rehabilitation outcomes in Operations Enduring Freedom and Iraqi Freedom veterans and may provide a non-stigmatizing entry to mental health services.