Examining the Effect of Acupuncture on Sleep Difficulties Related to Post Traumatic Stress Disorder

Background: Approximately 70-91% of veterans with Post-Traumatic Stress Disorder (PTSD) report insomnia. Presently, conventional treatments for PTSD-related insomnia include medications, psychotherapy, and cognitive behavioral therapy. While some of these conventional treatments do improve PTSD-related insomnia, many of these treatments have limitations (e.g., medication effects, lengthy time commitments, psycho-social stigma). Because of these limitations, many veterans are increasingly turning to complementary and alternative therapies to relieve their symptoms. There is a growing body of research that shows that acupuncture may improve many health symptoms including depression, PTSD, addiction, headaches, musculoskeletal pain, and insomnia. However, to date, no study has specifically explored how acupuncture may affect PTSD-related insomnia. Because so many veterans with PTSD experience PTSD-related insomnia, and because the current conflicts in Southwest Asia are producing a new generation of combat veterans, it is critical that the VA explore innovative treatments for PTSD-related health concerns.

Inclusion criteria

• Combat veteran of Operation Iraqi Freedom or Operation Enduring Freedom conflicts;
• Diagnosed with Post Traumatic Stress Disorder (PTSD) per Diagnostic Statistical Manual (DSM) IV criteria;
• Have insomnia as indicated by a score equal to or greater than 8 on the Insomnia Severity Index (ISI);
• Diagnosis of insomnia made after PTSD diagnosis; and
• If on psychotropic medications, must be on stable psychotropic medication regimen for one month prior to enrollment in study.

Exclusion criteria

• Does not speak English;
• Not competent to sign informed consent;
• History of moderate or severe traumatic brain injury
• Start use of Continuous Positive Airway Pressure (CPAP) or Bilevel Positive Airway Pressure (BiPAP) during the study.
• Experiencing severe psychiatric illness defined as suicidal ideation, homicidal ideation, or psychosis;
• History of substance abuse Dependence (as defined per DSM IV criteria) during the one year preceding enrollment in the study OR history of illicit substance use for 3 months prior to study enrollment OR positive Audit C score at study enrollment (defined as score of 5 and above).
• Received acupuncture during past 3 months.
• On Coumadin, Heparin, or Lovenox
• Pregnancy