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Individual Three Minute Open Paper

Conflict, Disasters, and Trauma- and Stressor-related Disorders

Innovations in CBT: Expanding Impact Through Mechanisms, Equity, and Training

2 - (3 MIN 3) Differential Associations Between Sleep Domains and response to Prolonged Exposure Therapy

Thursday, June 25, 2026
2:15 PM - 2:25 PM PDT
Location: Yerba Buena Salon 15, B3 Level
Keywords: PTSD (Posttraumatic Stress Disorder), Exposure, Sleep
Recommended Readings: Hunt, C., Park, J., Bomyea, J., & Colvonen, P. J. (2023). Sleep efficiency predicts improvements in fear extinction and PTSD symptoms during prolonged exposure for veterans with comorbid insomnia. Psychiatry research, 324, 115216. https://doi.org/10.1016/j.psychres.2023.115216,   Sexton, M. B., Davis, M. T., & Rauch, S. A. M. (2017). Examining the role of sleep disturbance in PTSD treatment outcomes. Behavior Therapy, 48(2), 208–218. https://doi.org/10.1016/j.beth.2016.09.003,   Park, N., Rouvere, J., Chase, E., Blanchard, B. E., Kaysen, D. L., Hendrickson, R. C., Fortney, J. C., & Cerimele, J. M. (2025). Associations among sleep quality, cognitive processing therapy, and posttraumatic stress disorder symptoms in a primary care setting. Journal of Traumatic Stress, 38(2), 1–11. https://doi.org/10.1002/jts.23132,   ,  
Prolonged Exposure (PE) is an effective evidence-based psychotherapy for posttraumatic stress disorder (PTSD); however, a small subset of veterans fails to achieve meaningful symptom reduction from PE. Given sleep’s role in memory consolidation, poor sleep quality may adversely affect fear extinction learning central to PE. Existing research on sleep and PE response often relies on single-item or global measures that miss nuanced sleep processes, assesses sleep as static (e.g., at baseline) rather than as a dynamic process, or focuses on concurrent rather than prospective associations. This study used a multidimensional measure of sleep quality to evaluate whether changes across several domains of sleep concurrently and prospectively predicted reduced PTSD symptoms. Sleep quality was assessed pre- and post-treatment and PTSD symptoms were measured pre- and post-treatment, and at 3- and 6-month follow-ups. Changes in sleep domains were analyzed as predictors of concurrent and prospective PTSD symptoms. Improvements in overall sleep quality, subjective sleep quality, and daytime dysfunction were associated with improvements in PTSD symptom severity from pre- to post-treatment. Greater improvements in overall sleep quality and daytime dysfunction predicted lower PTSD severity at follow-up; however, greater reductions in daytime dysfunction predicted symptom increases across follow-up. Findings highlight the importance of overall sleep quality in PE response and suggest daytime dysfunction due to sleep problems may contribute to diminished long-term outcomes. Targeting these aspects of sleep may enhance treatment efficacy.

Learning Objectives:

  • Upon completion, participant will be able to describe which factors related to sleep are most important important to treating PTSD with exposure therapy.