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Sleep Initiation and Maintenance Disorders: HELP
Articles by Sean P. A. Drummond
Based on 8 articles published since 2008
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Between 2008 and 2019, Sean P. A. Drummond wrote the following 8 articles about Sleep Initiation and Maintenance Disorders.
 
+ Citations + Abstracts
1 Review Piloting cognitive-behavioral therapy for insomnia integrated with prolonged exposure. 2019

Colvonen, Peter J / Drummond, Sean P A / Angkaw, Abigail C / Norman, Sonya B. ·VA San Diego Healthcare System. · Monash Institute for Cognitive and Clinical Neuroscience. · National Center for PTSD. ·Psychol Trauma · Pubmed #30211598.

ABSTRACT: OBJECTIVE: Approximately 35-61% of individuals with posttraumatic stress disorder (PTSD) report insomnia. Further, upward of 70% report clinically significant insomnia following PTSD treatment. There are converging lines of evidence suggesting that insomnia not only independently affects daytime functioning and worsens PTSD symptoms but also may compromise response to PTSD treatment, such as prolonged exposure (PE). Taken together, integrated insomnia and PTSD treatment may increase client-centered care and treatment outcomes. METHOD: This article reviews the theory and evidence for treating sleep prior to PTSD treatment, describes the key elements of integrated cognitive-behavioral treatment for insomnia (CBT-I) and PE (2NITE protocol), and presents pilot data from a sample of 12 treatment-seeking veterans with PTSD and insomnia who completed the 2NITE protocol. Sleep data were collected with sleep diaries and actigraphy watches. RESULTS: The Client Satisfaction Questionnaire indicated high satisfaction with the 2NITE protocol (mean score 29.66 out of 32 points). On average, there were statistical and clinically significant changes in all measures, including a 20.17-point decrease in the PTSD Checklist DSM-5, a 11.75-point decrease in the insomnia severity index, an 18.58-point increase in the World Health Organization Quality of Life index, a 11% increase in sleep efficiency, and a 51-min increase in total sleep time from the actigraphy data. CONCLUSIONS: Among individuals with insomnia and PTSD, integrating CBT-I and PE with the 2NITE protocol represents a logical, innovative, and empirically informed method for augmenting existing treatments and optimizing outcomes that justifies further investigation. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

2 Review Treating nightmares and insomnia in posttraumatic stress disorder: a review of current evidence. 2012

Nappi, Carla M / Drummond, Sean P A / Hall, Joshua M H. ·University of California, San Diego and Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, MC116B, San Diego, CA 92161, United States. cnappi@ucsd.edu ·Neuropharmacology · Pubmed #21396945.

ABSTRACT: Emerging evidence supports the notion of disrupted sleep as a core component of Posttraumatic Stress Disorder (PTSD). Effective treatments for nighttime PTSD symptoms are critical because sleep disruption may be mechanistically linked to development and maintenance of PTSD and is associated with significant distress, functional impairment, and poor health. This review aimed to describe the state of science with respect to the impact of the latest behavioral and pharmacological interventions on posttraumatic nightmares and insomnia. Published studies that examined evidence for therapeutic effects upon sleep were included. Some behavioral and pharmacological interventions show promise, especially for nightmares, but there is a need for controlled trials that include valid sleep measures and are designed to identify treatment mechanisms. Our ability to treat PTSD-related sleep disturbances may be improved by moving away from considering sleep symptoms in isolation and instead conducting integrative studies that examine sequential or combined behavioral and/or pharmacological treatments targeting both the daytime and nighttime aspects of PTSD. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.

3 Article Going direct to the consumer: Examining treatment preferences for veterans with insomnia, PTSD, and depression. 2018

Gutner, Cassidy A / Pedersen, Eric R / Drummond, Sean P A. ·National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA. Electronic address: cgutner@bu.edu. · RAND Corporation, Santa Monica, CA, USA. · Monash Institute for Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Australia. ·Psychiatry Res · Pubmed #29524908.

ABSTRACT: Inclusion of consumer preferences to disseminate evidence-based psychosocial treatment (EBPT) is crucial to effectively bridge the science-to-practice quality chasm. We examined this treatment gap for insomnia, posttraumatic stress disorder (PTSD), depression, and comorbid symptoms in a sample of 622 young adult veterans through preference in symptom focus, treatment modality, and related gender differences among those screening positive for each problem. Data were collected from veteran drinkers recruited through targeted Facebook advertisements as part of a brief online alcohol intervention. Analyses demonstrated that veterans reported greater willingness to seek insomnia-focused treatment over PTSD- or depression-focused care. Notably, even when participants screened negative for insomnia, they preferred sleep-focused care to PTSD- or depression-focused care. Although one in five veterans with a positive screen would not consider care, veterans screening for both insomnia and PTSD who would consider care had a preference for in-person counseling, and those screening for both insomnia and depression had similar preferences for in-person and mobile app-based/computer self-help treatment. Marginal gender differences were found. Incorporating direct-to-consumer methods into research can help educate stakeholders about methods to expand EBPT access. Though traditional in-person counseling was often preferred, openness to app-based/computer interventions offers alternative methods to provide veterans with EBPTs.

4 Article Assessment of Sleep Disruption and Sleep Quality in Naval Special Warfare Operators. 2015

Harris, Erica / Taylor, Marcus K / Drummond, Sean P A / Larson, Gerald E / Potterat, Eric G. ·Health and Behavioral Sciences Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106. · Warfighter Performance, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106. · Veterans Affairs Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161. · Naval Special Warfare Command, 2000 Trident Way, Building 603M, San Diego, CA 92155. ·Mil Med · Pubmed #26126252.

ABSTRACT: Little is known about sleep in elite military populations who are exposed to higher operational demands, unpredictable training, deployment, and mission cycles. Twenty-nine Naval Special Warfare (NSW) Operators wore an actiwatch for an 8-day/7-night period for objective sleep assessment and completed a nightly sleep log. A total of 170 nights of actigraphically recorded sleep were collected. When comparing objectively versus subjectively recorded sleep parameter data, statistically significant differences were found. Compared with sleep log data, actigraphy data indicate NSW Operators took longer to fall asleep (an average of 25.82 minutes), spent more time awake after sleep onset (an average of 39.55 minutes), and demonstrated poorer sleep efficiency (83.88%) (ps < 0.05). Self-reported sleep quality during the study period was 6.47 (maximum score = 10). No relationships existed between the objectively derived sleep indices and the self-reported measure of sleep quality (rs = -0.29 to 0.09, all ps > 0.05). Strong inter-relationships existed among the subjectively derived sleep indices (e.g., between self-reported sleep quality and sleep efficiency; r = 0.61, p < 0.001). To our knowledge, this is the first study to objectively and subjectively quantify sleep among NSW Operators. These findings suggest sleep maintenance and sleep efficiency are impaired when compared to normative population data.

5 Article Prevalence and Mental Health Correlates of Insomnia in First-Encounter Veterans with and without Military Sexual Trauma. 2015

Jenkins, Melissa M / Colvonen, Peter J / Norman, Sonya B / Afari, Niloofar / Allard, Carolyn B / Drummond, Sean P A. ·Department of Psychiatry, University of California, San Diego, CA. · Research Service, VA San Diego Healthcare System, San Diego, CA. · Psychology Services, VA San Diego Healthcare System, San Diego, CA. · Center of Excellence for Stress and Mental Health (CESAMH), San Diego, CA. · National Center for PTSD, White River Junction, VT. · School of Psychological Sciences, Monash University, Clayton, VIC, Australia. ·Sleep · Pubmed #26085301.

ABSTRACT: STUDY OBJECTIVES: There is limited information about prevalence of insomnia in general populations of veterans of recent wars in Iraq and Afghanistan. No studies have examined insomnia in veterans with military sexual trauma (MST). We assess prevalence of insomnia, identify types of services sought by veterans with insomnia, and examine correlates of insomnia in veterans with and without MST. DESIGN: A cross-sectional study of first-encounter veterans registering to establish care. SETTING: Veteran Affairs San Diego Healthcare System. PARTICIPANTS: Nine hundred seventeen veterans completed questionnaires assessing insomnia, MST, service needs, traumatic brain injury, resilience, and symptoms of depression, posttraumatic stress disorder (PTSD), pain, alcohol misuse, and hypomania. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: 53.1% of veterans without MST and 60.8% of veterans with MST had clinically significant insomnia symptoms, with the MST subsample reporting more severe symptoms, P < 0.05. Insomnia was more prevalent than depression, hypomania, PTSD, and substance misuse. Veterans with insomnia were more likely to seek care for physical health problems and primary care versus mental health concerns, P < 0.001. For the veteran sample without MST, age, combat service, traumatic brain injury, pain, and depression were associated with worse insomnia, P < 0.001. For the MST subsample, employment status, pain, and depression were associated with worse insomnia, P < 0.001. CONCLUSIONS: Study findings indicate a higher rate of insomnia in veterans compared to what has been found in the general population. Insomnia is more prevalent, and more severe, in veterans with military sexual trauma. Routine insomnia assessments and referrals to providers who can provide evidence-based treatment are crucial.

6 Article Sleep variability in military-related PTSD: a comparison to primary insomnia and healthy controls. 2015

Straus, Laura D / Drummond, Sean P A / Nappi, Carla M / Jenkins, Melissa M / Norman, Sonya B. ·San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA; Veterans Affairs San Diego Healthcare System, Research Service, San Diego, California, USA. ·J Trauma Stress · Pubmed #25630526.

ABSTRACT: Sleep disturbances are prevalent in posttraumatic stress disorder (PTSD) and are associated with a number of adverse health consequences. Few studies have used comprehensive assessment methods to characterize sleep in Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn (OEF/OIF/OND) veterans with PTSD. OEF/OIF/OND veterans with PTSD and sleep disturbance (n = 45) were compared to patients with primary insomnia (n = 25) and healthy control subjects (n = 27). Participants were assessed using questionnaire-based measures as well as daily subjective and objective measures of sleep. The 3 groups were compared with regard to (a) group means, (b) intraindividual (i.e., night-to-night) variability of sleep, and (c) interindividual (i.e., within-group) variability of sleep. In terms of group means, only objective sleep efficiency was significantly worse with PTSD than with primary insomnia (d = 0.54). Those with PTSD differed from those with primary insomnia on measures of intraindividual as well as interindividual variability (d = 0.48-0.73). These results suggested sleep symptoms in OEF/OIF/OND veterans with PTSD are more variable across nights and less consistent across patients relative to sleep symptoms in insomnia patients without PTSD. These findings have implications for research, as well as for personalizing treatment for individuals with PTSD.

7 Article Neural correlates of working memory performance in primary insomnia. 2013

Drummond, Sean P A / Walker, Matthew / Almklov, Erin / Campos, Manuel / Anderson, Dane E / Straus, Laura D. ·Psychology Service, VA San Diego Healthcare System, San Diego, CA 92161, USA. drummond@ucsd.edu ·Sleep · Pubmed #23997363.

ABSTRACT: STUDY OBJECTIVES: To examine neural correlates of working memory performance in patients with primary insomnia (PIs) compared with well-matched good sleepers (GSs). DESIGN: Twenty-five PIs and 25 GSs underwent functional MRI while performing an N-back working memory task. SETTING: VA hospital sleep laboratory and University-based functional imaging center. PATIENTS OR PARTICIPANTS: 25 PIs, 25 GSs. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Although PIs did not differ from GSs in cognitive performance, PIs showed the expected differences from GSs in both self-reported and objective sleep measures. PIs, relative to GSs, showed reduced activation of task-related working memory regions. This manifested both as an overall reduction in activation of task-related regions and specifically as reduced modulation of right dorsolateral prefrontal cortex with increasing task difficulty. Similarly, PIs showed reduced modulation (i.e., reduced deactivation) of default mode regions with increasing task difficulty, relative to GSs. However, PIs showed intact performance. CONCLUSIONS: These data establish a profile of abnormal neural function in primary insomnia, reflected both in reduced engagement of task-appropriate brain regions and an inability to modulate task-irrelevant (i.e., default mode) brain areas during working memory performance. These data have implications for better understanding the neuropathophysiology of the well established, yet little understood, discrepancy between ubiquitous subjective cognitive complaints in primary insomnia and the rarely found objective deficits during testing.

8 Article Effectiveness of imagery rehearsal therapy for the treatment of combat-related nightmares in veterans. 2010

Nappi, Carla M / Drummond, Sean P A / Thorp, Steven R / McQuaid, John R. ·Veteran Affairs San Diego Healthcare Systems, 3350 La Jolla Village Dr., MC 151B, Building 13, 3rd floor, San Diego, CA 92161, USA. drummond@ucsd.edu ·Behav Ther · Pubmed #20412888.

ABSTRACT: Imagery Rehearsal Therapy (IRT) has been shown to be efficacious in reducing nightmares, but the treatment has not been well-studied in veterans. The effectiveness of IRT was assessed from a chart review of veterans seeking outpatient treatment for chronic, trauma-related nightmares. Of those offered IRT, veterans who completed a full course of treatment for PTSD in the past year were more likely to initiate treatment. However, completion of IRT was not related to previous treatment, demographic variables, or nightmare severity reported at the first treatment session. Treatment completers reported significant reductions in nightmare frequency and intensity, severity of insomnia, and subjective daytime PTSD symptoms. Insomnia and PTSD symptoms, on average, were below clinical cutoffs following treatment, and 23% of patients showed a complete treatment response (< or =1 nightmare/week). Findings suggest IRT may be an effective short-term treatment for nighttime and daytime PTSD symptoms among veterans who complete a full course of treatment.