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Hi everyone, my name is Destiny Piper and I'm currently a full time graduate student at Logan University and studying at FRCC full time for my health and wellness coaching certificate. I am a mother of two crazy little girls and 12 fur babies. My family is blessed to live on a little over 6 acres of land which we are turning into a farmstead. I've always had a passion for helping people, and ever since getting out of the military have wanted to work with fellow veterans to help them become more mindful of their health once they leave the military. Military service and veterans are close to my heart as it has been a family affair for me with myself, my husband, my brothers, and unces all serving in each branch of the military.

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The numbers of both active duty military and veterans that have sleeping disorders are high and continue to rise as the work/sleep schedules that they deal with and are used to dealing with are sporadic. Research has shown that insomnia-like symptoms and insomnia affect between 27-54% of active duty military and veterans. These rates are two to three times higher than the rates found in the US population.

(Hughes et al., 2018)

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Carlson, G. C., Kelly, M. R., Mitchell, M., Josephson, K. R., McGowan, S. K., Culver, N. C., Kay, M., Alessi, C. A., Fung, C. H., Washington, D. L., Hamilton, A., Yano, E. M., & Martin, J. L. (2022). Benefits of Cognitive Behavioral Therapy for Insomnia for Women Veterans with and without Probable Post-Traumatic Stress Disorder. Women’s Health Issues : Official Publication of the Jacobs Institute of Women’s Health, 32(2).

Hughes JM, Ulmer CS, Gierisch JM, Nicole Hastings S, Howard MO. Insomnia in United States military veterans: An integrated theoretical model. Clin Psychol Rev. 2018 Feb;59:118-125. doi: 10.1016/j.cpr.2017.11.005. Epub 2017 Nov 20. PMID: 29180102; PMCID: PMC5930488.

Jason G Ellis, Michael L Perlis, Colin A Espie, Michael A Grandner, Célyne H Bastien, Nicola L Barclay, Ellemarije Altena, Maria Gardani, The natural history of insomnia: predisposing, precipitating, coping, and perpetuating factors over the early developmental course of insomnia, Sleep, Volume 44, Issue 9, September 2021, zsab095, https://doi.org/10.1093/sleep/zsab095

Michael Perlis, Phd. Michael Perlis, PhD | Behavioral Sleep Medicine Program | Perelman School of Medicine at the University of Pennsylvania. (n.d.). https://www.med.upenn.edu/bsm/faculty_perlis.html

Miller, M. B., Carpenter, R. W., Freeman, L. K., Dunsiger, S., McGeary, J. E., Borsari, B., McCrae, C. S., Arnedt, J. T., Korte, P., Merrill, J. E., Carey, K. B., & Metrik, J. (2023). Effect of Cognitive Behavioral Therapy for Insomnia on Alcohol Treatment Outcomes Among US Veterans: A Randomized Clinical Trial. JAMA Psychiatry, 80(9), 905–913. https://doi-org.logan.idm.oclc.org/10.1001/jamapsychiatry.2023.1971

Rigley, J., Neilson, C., Murphy, D., & Watson, F. (2022). How effectively does CBT-I address the traumatic and functional causes of insomnia and sleep disturbance in Veterans? Journal of Military, Veteran & Family Health, 8(3), 6–18. https://doi-org.logan.idm.oclc.org/10.3138/jmvfh-2021-0072a

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The most well known model surrounding insomnia as a disease state is the Spielman or “3P” model. This model conceptualizes insomnia across a trajectory that develops from a normal sleep pattern to a pattern of chronic insomnia with there being two transition points labeled acute (onset of insomnia) and early (short-term) insomnia. The framework for this model states that there are three levels of influence in insomnia and these levels include predisposing, precipitating, and perpetuating factors. Predisposing factors are those that are things such as personality traits, precipitaiting factors are those such as stressors, and finally perpetuating factors are those such as behaviors and cognitions which further inhibit the sleep process, and learned negative associations. These levels will continue to build on each other in a way that keeps the individual in a state of insomnia. (Jason et al., 2021)

Cognitive Behavioral Therapy for Insomnia has been an upcoming treatment for insomnia within veterans as it encompass a variety of factors to help treat the symptoms and levels associated with the development of insomnia within this population that they may not address outside of treatment with their doctor or sleep specialist. (Rigley et al., 2022)

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Dr. Michael Prelis is one of the key figures when you talk about cognitive behavioral therapy for insomnia in veterans. He is most well known for his work and research into Behavioral Sleep Medicine (BSM) and the publishing of CBT-I manual. He also conducts training workshops for CBT-I each year and mentors 95 trainees in his field of study.

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One study was conducted into the use of CBT-I in women veterans with and without PTSD to see if this therapy could help with insomnia in this population. What the researchers found was that in the women who participated in this study showed improvements in sleep quality, insomnia, and diary sleep efficency and TST from baseline to post-treatment and then a 3-month follow up. (Carlson et al., 2022)

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Another issue that many veterans may face once they are no longer in service is a continued dependance on substances such as alcohol to help them cope with their day to day functioning. Research has shown that veterans who are participating in cognitive behavioral therapy for insomnia on top of treatment of alcohol related problems reported a greater decrease in insomnia and insomnia symptoms at posttreatment and at follow-up. (Miller et al., 2023)

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Moving foward, once I recieve my health and wellness coaching certificate and I complete my Ph.D, I plan on opening my own health and wellness coaching practice, with a focus on nutritional wellness. I want to continue to be a good example for my daughters and fellow veterans to show them that life is truly what you make of it.