Restoring peaceful sleep

For many Veterans, the transition from military service to civilian life is often accompanied by difficulties with sleep, especially for those with lingering trauma.

Insomnia-and nightmares in particular-plague the sleep of countless Veterans.

Fortunately, VA offers specialized treatments to help Veterans reclaim their sleep and improve their overall well-being. Dr. Kimberly Igirio, staff psychologist at Orlando VA Medical Center, is at the forefront of this effort, offering proven therapy methods that are transforming lives.

Army and Navy Veteran Ray Best's service aboard the USS Iowa in the 1980s was marked by a tragic event that sadly claimed the lives of 47 of his fellow shipmates, a memory that continues to haunt Best decades later. His survivor's guilt and nightmares stemming from this tragedy have been a long-standing burden on his mental health.

Best initially approached therapy with skepticism. "When I first heard about it, I thought what new-age nonsense is this?" However, after being referred to Igirio, he realized VA's therapy programs were much more than he expected.

Cognitive Behavioral Therapy for nightmares

"Dr. Igirio didn't treat me like a number or just another patient. She genuinely cares about the people she sees and that makes a big difference," Best shared.

The treatment for Best centers on a method called Cognitive Behavioral Therapy for Nightmares (CBT-N). It's designed to help Veterans confront and manage their trauma-induced nightmares. It also incorporates relaxation techniques and builds on CBT for Insomnia (CBT-I), an older treatment built to help those struggling to fall asleep or stay asleep. According to Igirio, CBT-I has a long track record of effectively helping people to improve their quantity and quality of sleep in five to eight weeks.

"Nightmares are often the brain's way of coping with the trauma. Through CBT-I, Veterans like Best face their nightmares head-on using a process called rescripting, which allows the brain to process unresolved thoughts and emotions," Igirio said.

"Writing down what I'm thinking before bed helps clear my mind. I've also learned breathing exercises and progressive muscle relaxation, which have helped me relax both mentally and physically," Best said, describing the tools he has learned from therapy sessions with Igirio.

"I'm easier to be around now."

Before treatment, Best was only getting three to four hours of broken sleep a night, often interrupted by vivid distressing nightmares. These recurring dreams left him exhausted, irritable and unable to focus during the day. Since starting therapy, he's noticed significant improvements.

"I'm getting about six hours of sleep now. It's still broken sleep, but it's a lot better than it was. I might have one nightmare a night for a few nights in a row and then go two or three days without one," he said.

Best's improved sleep has had a positive ripple effect on his life. "When you're rested, your day is better. I'm easier to be around now and I don't get agitated as easily," he added.

For Best, therapy has been life changing and has meant so much that he presented Igirio with a special challenge coin commemorating the USS Iowa, a token of his deep appreciation for the exceptional care and support he has received. (Pictured above.)

"With improved sleep and mental health, Best continues to honor the memory of his shipmates while moving forward in his own life," Best said.

Veterans interested in addressing their sleep are encouraged to speak with their primary care provider about behavioral therapy options.

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