Predictors of Response to Insomnia Treatments for Gulf War Veterans

Inclusion Criteria: * Male or female Gulf War Veterans of any racial or ethnic group * Independent Living (not in nursing home or VA Extended Care facility) * Subjective complaint of insomnia on the Insomnia Severity Index (ISI) greater than or equal to 10 * Subjects with PTSD will be included in this study as long as they do not meet criteria for depression described below * Stable (3 weeks) CNS active medications that could significantly impact sleep or alertness * Stable adult onset diabetes, controlled with insulin, oral medications or diet is acceptable * Access to a device with video capabilities and ability to have the video on during study visits. Exclusion Criteria: Sleep-Related * Excessive caffeine consumption (4 or more cups of coffee per day) and unable to reduce to 3 cups or less a day before lunch a day for 3 weeks prior to treatment * Subjects will be initially screened by the Berlin Questionnaire (for sleep apnea) * Those with responses suggestive of high risk for sleep apnea will be referred to Pulmonary Medicine for standard clinical screening including polysomnography * Those where apnea is primarily responsible for their sleep complaints will be excluded * Subjects working a rotating shift or an unconventional daytime shift (ending after 1830h) will be ineligible Neuropsychiatric * Hamilton Depression Scale (HDRS 24) and classified as high risk on the Columbia Suicide Severity Rating Scale (C-SSRS) in the past month * Individuals are considered high…