Can talking therapies help gulf war vets sleep better?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

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 risk if they have endorsement of either of the following on the C-SSRS: * A positive endorsement, relative to the past 30 days, in the "Suicide Thoughts" section of item #4 (Have you had these thoughts and had some intention of acting on them) or item #5 (Have you started to work out or worked out the details of how to kill yourself? Do you intend to carry out this plan? * A positive endorsement, relative to the past 90 days, in the "Suicide Behavior" section of item #6 (Have you ever done anything, started to do anything, or prepared to do anything to end your life?) * Current or lifetime history of a psychiatric disorder with primary psychotic features * Current or lifetime bipolar disorder; prominent suicidal or homicidal ideation * Current exposure to trauma, or exposure to trauma in the past 3 months * Current or within the past 30 days: drug abuse or dependence (except nicotine) * Current or expected cognitive behavior therapy for another condition (e.g.,: depression) * Excessive alcohol consumption of \>14 drinks per week or \> 4 drinks per occasion * Presence of any acute or unstable psychiatric condition(s) that requires referral for treatment * Montreal Cognitive Assessment (MOCA) \< 20 or Montreal Cognitive Assessment Blind (MOCA-Blind) \< 15 Medical * Acute or unstable chronic illness, including but not limited to: * Uncontrolled thyroid disease * Kidney disease * Prostate or bladder conditions causing excessively frequent urination (\> 3 times per night) * Medically unstable congestive heart failure * Angina * Other severe cardiac illness as defined by treatment regimen changes in the prior 3 months * Stroke with serious sequelae * Cancer if \< 1 year since end of treatment * Asthma * Emphysema * Other severe respiratory diseases uncontrolled with medications * Neurological disorders such as Alzheimer's disease, Parkinson's disease, and/or unstable epilepsy as defined by treatment regimen changes in the prior 3 months * Unstable adult-onset diabetes will be excluded