The TIRED trial - Transdiagnostic Intervention for Remote Ex-military and first-responDers study

INTERVENTION: The primary intervention in this trial is the Transdiagnostic Intervention for Sleep Disorders and Circadian Rhythms (TranS‐C). Trans‐C is a module driven approach incorporating aspects of all evidence based psychological approaches to the treatment of sleep problems. Trans‐C is a module driven approach incorporating aspects of all evidence based psychological approaches to the treatment of sleep problems. The TranS‐C intervention consists of four cross‐cutting models, four core modules and seven optional modules delivered over 4‐10 sessions depending on the complexity of the presentation (Harvey & Buysse, 2018). Participants will be with individual participants, who will receive between 4 – 10 weekly 50‐minute sessions. This intervention will be delivered by registered psychologists and the mode of delivery will be via telehealth (specifically, videoconferencing). The intervention is a manualised modular treatment and treatment sessions vary depending on presentation of sleep disorder symptoms. The location of treatment will be in the participants' own homes using video and audio enabled devices. The therapy will be delivered by psychologists within the Phoenix Australia Traumatic Stress Clinic. Treatment will be delivered according to the Transdiagnostic Sleep and Circadian Intervention clinician manual (Harvey et al. 2018). Sessions will be audio recorded for the purposes of fidelity testing. ten percent of audio recordings will be accessed by senior members of trial team for purpose of fidelity testing. A key component of treatment involves the completion of daily sleep diary entries to track/monitor sleep habits. Using an ecological‐momentary‐assessment framework, a digitised version of the TranS‐C sleep diary is utilised in this trial to enable participants CONDITION: Mental Health ‐ Other mental health disorders Neurological ‐ Other neurological disorders Sleep Disorders;Posttraumatic Stress Disorder; ; Sleep Disorders ; Posttraumatic Stress Disorder PRIMARY OUTCOME: Satisfaction of telehealth treatment delivery‐‐assessed using the Teleneuropsychology Patient Experience Survey[Posttreatment ‐ 2 weeks after treatment completion ] Satisfaction with the TranS‐C treatment‐‐assessed using the Client Satisfaction Questionnaire[posttreatment ‐ 2 weeks after treatment completion ] Severity of sleep symptoms‐‐assessed using the Pittsburgh Sleep Quality Index (PSQI). [posttreatment ‐ 2 weeks after treatment completion ] INCLUSION CRITERIA: 1) Aged 18 years or older. 2) Are a Victorian‐based veteran or first responder 3) Have access to an electronic device offering audio‐visual connectivity to Zoom. 4) Meet criteria for diagnosable sleep disorder. 5) Are able to maintain a stable dose throughout the assessment and treatment period if on a pre‐existing medication. SECONDARY OUTCOME: Alcohol use severity ‐ assessed with Alcohol Use Disorders Identification Test (AUDIT)[posttreatment, follow‐up (3‐months posttreatment)] Posttraumatic Stress Disorder diagnosis‐ assessed with PTSD module of the Mini International Neuropsychiatric Interview (MINI) [posttreatment, follow‐up (3‐months posttreatment)] Posttraumatic Stress Disorder severity‐assessed using the PTSD Checklist for DSM‐5 (PCL‐5) [posttreatment, follow‐up (3‐months posttreatment)] Sleep disorder diagnosis ‐ assessed using The Structured Clinical Interview for DSM‐5 Sleep Disorders ‐ Revised[posttreatment, follow‐up (3‐months posttreatment)] Symptoms of Anxiety‐‐assessed using the Generalized Anxiety Disorder 7‐item scale (GAD7)[posttreatment, follow‐up (3‐months posttreatment)] Symptoms of depression‐‐assessed using the Patient Health Questionnaire‐9 (PHQ9)[posttreatment, follow‐up (3‐months posttreatment)]