A Pilot Randomized Controlled Trial of Telehealth-Delivered Transdiagnostic Intervention for Sleep Disorders and Circadian Rhythms (TranS-C) Among Ex-Military Personnel and First Responders

Abstract

Objective

Sleep and circadian problems are highly prevalent in ex-military personnel and first responders and often impact comorbid mental health disorders. This study tested the feasibility and efficacy of a transdiagnostic intervention—transdiagnostic intervention for sleep and circadian dysfunction (TranS-C)—in improving sleep problems and comorbid mental health symptoms in ex-military personnel and first responders with sleep and circadian disorder(s).

Method

A parallel-group, assessor-blinded, pilot randomized controlled trial design was employed. Forty first responders and ex-military personnel meeting the criteria for sleep disorder were randomized to receive immediate TranS-C or delayed TranS-C (n = 20 per condition) via telehealth. An assessment battery at pretreatment, posttreatment, and 3 months posttreatment was completed. The primary outcome was severity of sleep problems. Secondary outcomes included severity of posttraumatic stress disorder, depression, and anxiety symptoms.

Results

TranS-C treatment was associated with large pre- to posttreatment improvements in sleep problems (d = −0.97, p < .001) and depressive symptoms (d = −0.83, p < .001), as well as medium-to-large improvements in anxiety (d = −0.59, p < .001) and posttraumatic stress disorder (d = −0.69, p < .001) symptoms, with improvements maintained over time. The immediate TranS-C group had significantly greater sleep improvement after 12 weeks than the delayed TranS-C group, which, at this time, had not received treatment. After receiving treatment, symptoms in the delayed TranS-C group improved to similar posttreatment and follow-up levels as the immediate TranS-C group.

Conclusions

In ex-military personnel and first responder populations, TranS-C is an effective treatment that simultaneously addresses sleep and circadian disorders and comorbid mental health symptoms.