A review of behavioral treatments for sleep disturbances in civilians who have experienced trauma

Roche and colleagues hunted for every paper that tested behavioral sleep fixes on adults or teens who lived through trauma.

They screened 17 studies. Some used relaxation, others changed bedtime habits, and a few tried full CBT-I packages.

The team graded each study for quality, then asked: do these tricks really help trauma survivors fall and stay asleep?

Behavioral plans worked, but the proof was shaky. Stronger studies showed smaller gains, while weaker studies looked amazing.

The authors warn: pick your sleep tool from the better trials, not from the flashy but sloppy ones.

Sirao et al. (2026) looked at kids with autism, not trauma. They found exercise beats melatonin and pure behavior plans. This seems to clash, but the kids are different, and exercise is still a behavior plan—just one that tires the body first.

McLay et al. (2021) and Magaña et al. (2013) extend Roche’s message. They show that when you first test why a child with autism wakes up—attention, escape, sensory—then tailor the plan, sleep jumps. The same logic should work for trauma adults: assess, then act.

Symons et al. (2005) came earlier and pushed any quick behavioral help after trauma. Roche now tightens the focus to sleep only and adds a quality filter, superseding the old “try anything” stance.

You can calm trauma-nightmares without pills. Start with a brief sleep interview, add one evidence-based tactic—like scheduled worry time or a wind-down routine—and track nights with a simple log. If the data don’t budge in two weeks, dig deeper into function, just like Laurie and Sandy did with kids.