0378 OCCUPATIONAL THERAPIST DELIVERED COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA TO POST-9/11 VETERANS IN COLLEGE: A WAIT LIST CONTROL PILOT STUDY

Abstract Introduction: The prevalence of chronic insomnia in post-9/11 Veterans is substantial, especially for those with service-connected injuries. Veterans’ access to cognitive behavioral therapy for insomnia (CBT-I) is limited and expanding access to CBT-I is a critical need. Sleep is an area of concern for occupational therapists (OTs) and studies of OT-delivered CBT-I are warranted to ensure safe and effective care. Methods: Design: Wait list control pilot study. Sample: 6 treatment (1 female) and 8 wait list control (1 female) post-9/11 Veterans with service-connected injuries and chronic insomnia in college. Intervention: 7-weeks of multi-component CBT-I (i.e., sleep restriction, stimulus control, psycho-education, sleep hygiene, and mindfulness) delivered by OTs with advanced training in CBT-I using weekly 1-hour group meetings concurrent with weekly individual meetings. Outcomes: Insomnia Severity Index, Patient Health Questionnaire-Depression, Generalized Anxiety Disorder 7-item, Perceived Stress Scale, Dysfunctional Beliefs about Sleep, PROMIS-Satisfaction with Social Roles, Engagement in Meaningful Activities Survey. Sleep Onset Latency (SOL), Wake after Sleep Onset (WASO), Total Sleep Time (TST), and Sleep Efficiency (SE) were collected only in the treatment group. All data were collected using an internet-based interface. Analyses: 2X2 (condition X time) repeated measures ANOVA and paired t-test (SOL, WASO, TST, SE) with Generalized Eta-Squared (GES) effect sizes (.01 = small, .06 = medium, .14 = large). Results: The treatment group had reduced insomnia (p < .001; GES = .27), depression (p = .02; GES = .05), anxiety (p = .02; GES = .04), and stress (p = .01; GES = .07), fewer dysfunctional sleep beliefs (p < .001; GES = .39), trending greater social role satisfaction (p = .07; GES = .11) and meaningfulness in daily activities (p = .08; GES = .06); and reduced SOL (p = .03; GES = .48) and higher SE (p = .04; GES = .44) with non-significant changes found in WASO (p = .11) and TST (p = .20). There were no adverse events. Conclusion: It is feasible for OTs trained in multi-component CBT-I to safely and effectively deliver CBT-I to Veterans with service-connected injuries in college. Support (If Any): Wounded Warrior Project grant awarded to Dr. Eakman.