High leverage · often skipped
Treat insomnia as its own condition. CBT-I is first-line for chronic insomnia. Imagery rehearsal and (sometimes) prazosin target nightmares.
CBT-I has strong insomnia evidence. Nightmare meds and IRT are separate from a global PTSD protocol. Sleep gains often unlock other therapy.
VA sleep clinics, Whole Health, and trained civilian CBT-I clinicians. Apps exist; a protocol with a clinician is stronger.
Do not treat “I don’t sleep” only with more benzodiazepines. That fights the PTSD guideline.
Evidence reviewed September 2026. Named sources are being added room by room; start with VA/DoD PTSD guideline (2023) for first-line care.
