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| Studies for Veterans Only - ISFeRe Study |
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 Background Information |
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Sleep disruption following deployment increases the risk of poor outcomes, whereas the persistence of consolidated sleep is associated with psychological resilience. Although sleep disruption is an inherent challenge that characterizes military operations, sleep disruption often persists even after operations are completed. The persistence of chronic sleep disturbances post-deployment compromises psychological resilience, and is associated with heightened risk of occurrence or recurrence of psychiatric disorders in military and civilian population. Sleep disturbances can adversely affect neural circuits involved in threat and reward responses that are involved in the pathophysiology of disorders such as PTSD, MDD and addiction. These neural circuits, the reward and threat circuits, are critical to normal behavior, resilience, and psychiatric disorders.
If sleep disruption, and specifically insomnia, is a threat to psychological resilience (as expressed by increased risk for and prevalence of PTSD, MDD, suicidality, addictive disorders, and other health risk behaviors in adults with chronic insomnia) by disrupting underlying threat and reward brain circuits, then sleep consolidation through effective treatments may normalize aberrant neural threat and reward responses, and enhance psychological resilience or accelerate recovery from chronic, maladaptive stress reactions. To test this hypothesis, we will focus on insomnia, the most prevalent deployment-related sleep disturbance in returning military veterans. We will use the brief behavioral treatment of insomnia – military version (BBTI-MV) to explore whether sleep treatment normalizes threat and reward responses in combat-exposed military veterans using well established fMRI paradigms before and after treatment.
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