Targeting sleep quality in acutely traumatized individuals to reduce the risk for PTSD: study protocol for a multicentre randomized clinical trial

<b>Background:</b> There is a great need for feasible interventions in the initial period after a trauma that minimize the risk of developing a clinically relevant PTSD. The majority of people suffer from severe sleep disorders after a traumatic event. Because sleep is essential for processing emotional memories, we aim to improve sleep quality in acutely traumatized patients to benefit adaptive trauma processing and thereby prevent PTSD development.<b>Objective:</b> In a multicentre randomized controlled trial (RCT), we will investigate whether digital cognitive behavioural therapy for insomnia (dCBT-I) has the potential to not only increase sleep quality in acutely traumatized individuals but also reduce trauma-related symptoms (specific PTSD symptoms as well as related symptoms such as depression, anxiety and functional outcomes) and the risk for PTSD development in acutely traumatized individuals. Moreover, we will test if sleep disturbances pre-therapy predict the development of later PTSD symptoms.<b>Method:</b> We aim to recruit 104 patients who will be randomly assigned to an app-based sleep intervention utilizing CBT-I or a sleep diary as an add-on to treatment-as-usual (TAU) in outpatient acute trauma centres. Sleep quality, PTSD symptoms and everyday functioning will be measured before, after the intervention and at a 6-month follow-up.<b>Conclusion:</b> To our knowledge, this multicentre RCT is the first study to use dCBT-I as an early intervention for trauma. It may improve the understanding of the role of sleep in the development of PTSD and has the potential to contribute to the development of an easy-to-use early intervention for acutely traumatized individuals.