# Enhancing Mental Health and Cognitive Functioning in Victims of Violence: Cognitive Behavioral Therapy for Sleep Disorders Among Journalists, Human Rights Defenders, and Relatives of Disappeared Persons in Mexico City

## TL;DR

A study in Mexico City found that treating sleep disorders with cognitive behavioral therapy improved mental health in victims of violence.

## Contribution

The study introduces cognitive behavioral therapy for sleep disorders in high-risk populations affected by violence.

## Key findings

- 80% of participants showed post-traumatic stress disorder symptoms, and 95.7% reported poor sleep quality.
- Cognitive behavioral therapy improved sleep quality and reduced depression, anxiety, and PTSD symptoms.
- Neuropsychological tests revealed cognitive impairments linked to sleep disorders in some participants.

## Abstract

In Mexico, pervasive violence, forced disappearances, and homicides have deeply impacted certain groups, particularly journalists, activists, and human rights defenders, who are at high risk of victimization. While these groups receive state support for physical and legal safety, mental health and sleep-focused interventions remain insufficient. Collaborating with a Mexico City-based institution supporting human rights defenders and journalists, we conducted a psychometric assessment of 47 individuals affected by violence. Results showed that 80% exhibited symptoms of post-traumatic stress disorder, 25.5% showed depression, and 57.4% displayed anxiety; 95.7% reported poor sleep quality based on the Pittsburgh Sleep Quality Index. In a second phase, neuropsychological tests and polysomnographic recordings identified cognitive impairments in attention, memory, and decision-making in some participants, along with sleep disorders such as insomnia, primary snoring, obstructive sleep apnea, and bruxism. A third phase introduced Cognitive Behavioral Therapy for insomnia, nightmares, and circadian rhythm issues. Results showed improvements in sleep quality, total sleep time, and a reduction in depression, anxiety, and post-traumatic stress disorder symptoms. This approach suggests that treating sleep issues in high-risk populations can improve mental health.